Wasting Syndrome is a predictor of early death in Spastic Cerebral Palsy

Objectives: Children with spastic Cerebral Palsy have difficulties in sucking, swallowing and feeding leading to malnutrition, wasting and impaired cough reflex predisposing to pneumonia. This ultimately reduces quality of life and leads to early death. The study was conducted to calculate the predictive value of mortality in spastic Cerebral Palsy and severe wasting. Methodology: This prospective and longitudinal study was conducted in Rangpur Mother and Children Hospital, Bangladesh. A data base of 525 children suffering from Cerebral Palsy was prepared appearing in Child Development Center of this Hospital from 1st January 2016 to 31st Dec 2017. These samples were followed fortnightly up to 31st Dec 2021 with no extra intervention except physiotherapy. Among these samples, the children who had term delivery, perinatal asphyxia and post natal convulsion, required hospital admission in early postnatal period, had quadriplegia with severe muscle spasticity and wasting, muscle weakness of GMFCS grade IV and V, body weight < 3SD and MUAC <3SD were regarded as wasting syndrome and included in analysis. Results: Maximum number (63.0%) of cases was suffering from spastic type of Cerebral Palsy. Among spastics, quadriplegia was present in 68.5% of cases. Among these quadriplegic children 8.6% developed wasting syndrome and 42.9% died within the study period. The immediate cause was pneumonia. Positive predictive value was 0.75 and negative predictive value was 0.95. Conclusion: A significant number of children of spastic Cerebral Palsy develop severe wasting and early death.
Keywords: Spastic cerebral palsy, wasting syndrome, early death