Neurodevelopmental and socioemotional outcome and quality of life in children admitted to the paediatric intensive care unit: A retrospective study

Abstract

AIMS & OBJECTIVES: To determine the prevalence of neurodevelopmental and socioemotional impairments in children following PICU discharge and their association with quality of life. METHODS: The status of children admitted to the PICU (>24hrs) between 2014-2017 was assessed through survey. Caregivers of PICU survivors were invited to complete neurodevelopmental screeners: Ages and Stages Questionnaire (ASQ)(1-47mths) or Strengths and Difficulties Questionnaire (SDQ)(48mths-18yrs) and the Paediatric Quality of Life (PedsQL) Inventory, providing 2-4 year follow up. Cardiac diagnoses were excluded. Associations between neurodevelopment, clinical and demographic characteristics were assessed using Fisher's Exact Test. RESULTS: A total of 230 caregivers completed the survey. Median child age at admission was 1.71 years (IQR 0.34,6.83) and PICU length of stay (47.41hrs (33.50,86.51). Seventeen percent (n = 27) of caregivers perceived their child's development as worse post PICU admission. Overall, 23% of young children and 24% of older children met criteria for impairment (ASQ n = 79; SDQ n = 132). There was no significant association between age, elective admission, diagnosis, duration of mechanical ventilation, PIM3 or PICU/Hospital length of stay (p>0.20). Thirty-three percent of parents reported their child's quality of life as poor (PedsQL n = 204). Quality of life was significantly associated with ASQ (□2(1)=21.93,p<.000) and SDQ (□2(1)=15.26,p<.000). CONCLUSIONS: This small, single centre study found a quarter of children have evidence of significant neurodevelopmental or socio-emotional impairment following PICU admission, impacting on their quality of life. Further data is needed to examine premorbid status and PICU treatments associated with poorer post PICU outcomes in a larger prospective study.L6347729402021-04-21 <br />