Long-term effect of botulinum toxin A on the hip and spine in cerebral palsy: A national retrospective cohort study in Taiwan.

<h4>Objectives</h4>To investigate the effect of botulinum toxin A (BTA) on the development of hip dislocation and scoliosis, surgical rates for hip and spine, and mortality in cerebral palsy (CP).<h4>Study design</h4>A cohort study was conducted using CP data from a Taiwan Na...

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Autores principales:	Ching-Yueh Lin, Chi-Hsiang Chung, Dennis J Matthews, Heng-Yi Chu, Liang-Cheng Chen, Sung-Sen Yang, Wu-Chien Chien
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/e58a076f39064d90aaabc71398ff764e
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spelling	oai:doaj.org-article:e58a076f39064d90aaabc71398ff764e2021-12-02T20:06:35ZLong-term effect of botulinum toxin A on the hip and spine in cerebral palsy: A national retrospective cohort study in Taiwan.1932-620310.1371/journal.pone.0255143https://doaj.org/article/e58a076f39064d90aaabc71398ff764e2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255143https://doaj.org/toc/1932-6203<h4>Objectives</h4>To investigate the effect of botulinum toxin A (BTA) on the development of hip dislocation and scoliosis, surgical rates for hip and spine, and mortality in cerebral palsy (CP).<h4>Study design</h4>A cohort study was conducted using CP data from a Taiwan National Insurance Health Research Database. Diagnoses were defined using the International Classification of Diseases codes, 9th revision. Adjusted hazard ratios for outcomes were calculated using Cox regression analysis and adjusted for the following variables: BTA injection, sex, age, severities of CP, comorbidities, location, urbanization level, and level of care.<h4>Results</h4>A total of 1,405 CP children (670 female vs. 735 male), 281 in the BTA group and 1,124 in the controls, were followed-up for a mean of 5 years 4 months. There were no significant differences in the outcomes in both groups, in the incidence rates of hip dislocation and scoliosis, nor in the surgical rates for hip and spine surgery. Mortality rate in the BTA group was 0.49 times lower than that in the controls (p = 0.001). Moderate to severe types of CP had higher incidence rates of hip dislocation, scoliosis, hip surgery, spine surgery, and mortality.<h4>Conclusion</h4>Moderate to severe types of CP had poorer outcomes in all aspects, including a higher risk of hip dislocation, scoliosis, surgical rate for hip and spine, and mortality. Although BTA injection in children with CP proved to not significantly reduce hip dislocation and scoliosis, it is considered safe as an anti-spasticity treatment and may be beneficial for survival.Ching-Yueh LinChi-Hsiang ChungDennis J MatthewsHeng-Yi ChuLiang-Cheng ChenSung-Sen YangWu-Chien ChienPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0255143 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ching-Yueh Lin Chi-Hsiang Chung Dennis J Matthews Heng-Yi Chu Liang-Cheng Chen Sung-Sen Yang Wu-Chien Chien Long-term effect of botulinum toxin A on the hip and spine in cerebral palsy: A national retrospective cohort study in Taiwan.
description	<h4>Objectives</h4>To investigate the effect of botulinum toxin A (BTA) on the development of hip dislocation and scoliosis, surgical rates for hip and spine, and mortality in cerebral palsy (CP).<h4>Study design</h4>A cohort study was conducted using CP data from a Taiwan National Insurance Health Research Database. Diagnoses were defined using the International Classification of Diseases codes, 9th revision. Adjusted hazard ratios for outcomes were calculated using Cox regression analysis and adjusted for the following variables: BTA injection, sex, age, severities of CP, comorbidities, location, urbanization level, and level of care.<h4>Results</h4>A total of 1,405 CP children (670 female vs. 735 male), 281 in the BTA group and 1,124 in the controls, were followed-up for a mean of 5 years 4 months. There were no significant differences in the outcomes in both groups, in the incidence rates of hip dislocation and scoliosis, nor in the surgical rates for hip and spine surgery. Mortality rate in the BTA group was 0.49 times lower than that in the controls (p = 0.001). Moderate to severe types of CP had higher incidence rates of hip dislocation, scoliosis, hip surgery, spine surgery, and mortality.<h4>Conclusion</h4>Moderate to severe types of CP had poorer outcomes in all aspects, including a higher risk of hip dislocation, scoliosis, surgical rate for hip and spine, and mortality. Although BTA injection in children with CP proved to not significantly reduce hip dislocation and scoliosis, it is considered safe as an anti-spasticity treatment and may be beneficial for survival.
format	article
author	Ching-Yueh Lin Chi-Hsiang Chung Dennis J Matthews Heng-Yi Chu Liang-Cheng Chen Sung-Sen Yang Wu-Chien Chien
author_facet	Ching-Yueh Lin Chi-Hsiang Chung Dennis J Matthews Heng-Yi Chu Liang-Cheng Chen Sung-Sen Yang Wu-Chien Chien
author_sort	Ching-Yueh Lin
title	Long-term effect of botulinum toxin A on the hip and spine in cerebral palsy: A national retrospective cohort study in Taiwan.
title_short	Long-term effect of botulinum toxin A on the hip and spine in cerebral palsy: A national retrospective cohort study in Taiwan.
title_full	Long-term effect of botulinum toxin A on the hip and spine in cerebral palsy: A national retrospective cohort study in Taiwan.
title_fullStr	Long-term effect of botulinum toxin A on the hip and spine in cerebral palsy: A national retrospective cohort study in Taiwan.
title_full_unstemmed	Long-term effect of botulinum toxin A on the hip and spine in cerebral palsy: A national retrospective cohort study in Taiwan.
title_sort	long-term effect of botulinum toxin a on the hip and spine in cerebral palsy: a national retrospective cohort study in taiwan.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/e58a076f39064d90aaabc71398ff764e
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Long-term effect of botulinum toxin A on the hip and spine in cerebral palsy: A national retrospective cohort study in Taiwan.

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