{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T13:34:58Z","timestamp":1790775298244,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,2,6]],"date-time":"2019-02-06T00:00:00Z","timestamp":1549411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008475","name":"Brunel University London","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008475","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Develop Med Child Neuro"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To compare mortality rates for cardiovascular disease, cancer, and respiratory disease between adults with cerebral palsy (<jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content>) and the general population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A cohort study was conducted using data from adults with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> in England, identified through a primary care data set (the Clinical Practice Research Datalink), with linked data on death registrations from the Office for National Statistics. Cause of death was categorized according to International Classification of Diseases codes. Standardized mortality ratios (<jats:styled-content style=\"fixed-case\">SMR<\/jats:styled-content>s) were calculated to compare mortality rates between adults with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> and the general population, adjusted for age, sex, and calendar year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nine hundred and fifty\u2010eight adults with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> were identified (52.5% males, 47.5% females; median age at start of follow\u2010up 31y [interquartile range 22\u201343y]) and followed for a total of 7693 person\u2010years. One hundred and forty\u2010two patients (15%) died during follow\u2010up. Adults with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> had an increased risk of death due to cardiovascular disease (<jats:styled-content style=\"fixed-case\">SMR<\/jats:styled-content>: 3.19, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 2.20\u20134.62) and respiratory disease (<jats:styled-content style=\"fixed-case\">SMR<\/jats:styled-content>: 13.59, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 9.89\u201318.67), but not from malignant neoplasms (<jats:styled-content style=\"fixed-case\">SMR<\/jats:styled-content>: 1.42, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.83\u20132.45).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>We found that adults with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> in England have increased risk of death due to diseases of the circulatory and respiratory systems, supporting findings from two studies that compared cause\u2010specific mortality rates between adults with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> in the <jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content> and the general population. Further research is required into primary and secondary prevention of cardiovascular and respiratory disease in people with <jats:styled-content style=\"fixed-case\">CP<\/jats:styled-content> worldwide.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:p>\n<jats:list list-type=\"bullet\">\n\n<jats:list-item><jats:p>Adults with cerebral palsy (CP) in England have 14\u2010fold increased risk of mortality due to diseases of the respiratory system.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>They have a 3\u2010fold increased risk of mortality due to diseases of the circulatory system.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>Adults with CP had an increased risk of death due to cerebrovascular disease and ischaemic heart disease.<\/jats:p><\/jats:list-item>\n\n<jats:list-item><jats:p>The elevated risk of ischaemic heart disease, however, did not reach statistical significance at the 5% per cent level.<\/jats:p><\/jats:list-item>\n<\/jats:list>\n<\/jats:p><\/jats:sec>","DOI":"10.1111\/dmcn.14176","type":"journal-article","created":{"date-parts":[[2019,2,7]],"date-time":"2019-02-07T00:06:20Z","timestamp":1549497980000},"page":"924-928","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":115,"title":["Mortality due to cardiovascular disease, respiratory disease, and cancer in adults with cerebral palsy"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3768-2132","authenticated-orcid":false,"given":"Jennifer M","family":"Ryan","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Public Health Medicine Royal College of Surgeons in Ireland Dublin Ireland"},{"name":"Institute of Environment, Health and Societies Brunel University London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D","family":"Peterson","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation University of Michigan Medicine Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aberdeen Royal Infirmary Aberdeen UK"},{"name":"Department of Interventional Cardiology Hospital Cl\u00ednico San Carlos Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberley J","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Psychological Sciences Faculty of Health and Medical Sciences University of Surrey Guildford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil E","family":"O'connell","sequence":"additional","affiliation":[{"name":"Institute of Environment, Health and Societies Brunel University London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Liverani","sequence":"additional","affiliation":[{"name":"School of Mathematical Sciences Queen Mary University of London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nana","family":"Anokye","sequence":"additional","affiliation":[{"name":"Institute of Environment, Health and Societies Brunel University London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Victor","sequence":"additional","affiliation":[{"name":"Institute of Environment, Health and Societies Brunel University London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Allen","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics London School of Hygiene and Tropical Medicine London 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