Functional Outcomes and Physical Impairments in Pediatric Critical Care Survivors: A Scoping Review*

Ong, Ching Ching; Lee, Jan Hau; Leow, Melvin Khee–Shing; Puthucheary, Zudin

doi:10.1097/pcc.0000000000000706

Cited by 132 publications

(133 citation statements)

References 104 publications

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“…For example, 89.7% of pediatric critical care survivors admitted in 1995 had a favorable outcome with a likelihood of living independently and 83.6% had a favorable QOL at approximately 3.5 years after discharge as measured by the Health Utilities Index 1 (8) (17). Use of a more liberal definition of morbidity or a global measure with less precision may substantially alter our measured effect (8,27,30). Our study reflects similar results for a broader PICU population.…”

Section: Discussionsupporting

confidence: 58%

“…Notably, the FSS is not a patient-reported outcome measure but does not require significant training of personnel, lengthy time for administration, or adaptation to growth and developmental norms (23,30). Our assessment tool has the advantage of being easy to administer.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, the limited number of studies of children admitted in 2006 or later have focused on specific groups such as long-stay patients or the chronic critically ill population, health-related quality of life (HRQOL), or other outcomes with only 1-to 6-month follow-up (24)(25)(26)(27)(28). ), the focus on specific populations (e.g., preterm infants), and the variable duration of long-term follow-up impair our understanding of long-term outcomes (8,29,30). ), the focus on specific populations (e.g., preterm infants), and the variable duration of long-term follow-up impair our understanding of long-term outcomes (8,29,30).…”

mentioning

confidence: 99%

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Long-Term Function After Pediatric Critical Illness: Results From the Survivor Outcomes Study*

Pinto

Rhinesmith

Kim

et al. 2017

Pediatric Critical Care Medicine

192

150

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Long-Term Function After Pediatric Critical Illness: Results From the Survivor Outcomes Study*

Pinto

Rhinesmith

Kim

et al. 2017

Pediatric Critical Care Medicine

192

150

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“…A recent review found that new functional impairment at the time of ICU discharge was reported from 10% to 36% of discharges depending on the methodology used. 6 Evidence detailed below indicates that changes to functional status in critically ill children are tightly linked to physiological dysfunction (severity of illness).…”

Section: What Is Morbidity?mentioning

confidence: 99%

“…6 Depending on the method selected, a child’s deficits in specific domain(s) (e.g. motor ability, communication skills, etc.)…”

Section: Measuring Morbiditymentioning

confidence: 99%

Morbidity

Heneghan

Pollack

2017

Pediatric Clinics of North America

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The focus of critical care has evolved from saving lives to preservation of function. Morbidity rates in pediatric critical care are about double mortality rates. Morbidity includes complications of disease and medical care. In pediatric critical care, functional status morbidity is an intermediate outcome in the progression towards death, and is the result of the same factors associated with mortality including physiological profiles (PRISM), and case-mix factors. The Functional Status Scale (FSS) developed by CPCCRN, a NIH research consortium, is a validated, granular, age-independent measure of functional status that has proven valuable and practical even in large outcome studies.

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Epidemiology of Intensive Care Admissions for Children in the US From 2001 to 2019

et al. 2023

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ImportanceEstimates of the number of US children receiving intensive care unit (ICU) care and ICU admission patterns over time are lacking.ObjectiveTo determine how ICU admission patterns, use of critical care services, and the characteristics and outcomes of critically ill children have changed from 2001 to 2019.Design, Setting, and ParticipantsThis population-based retrospective cohort study used data from the Healthcare Cost and Utilization Project’s state inpatient databases from a total of 21 US states in 2001, 2004, 2010, 2016, and 2019. Hospitalized children aged 0 to 17 years, excluding newborns (during birth hospitalization), were included. Patients admitted to rehabilitation institutions or psychiatric hospitals were also excluded. Data were analyzed from July 2021 to December 2022.ExposuresCare in a nonneonatal ICU.Main Outcomes and MeasuresFrom extracted patient data, International Classification of Diseases, Ninth Revision, Clinical Modification, and Tenth Revision, Clinical Modification, codes were used to identify diagnoses, comorbid conditions, organ failures, and mechanical ventilation. Generalized linear Poisson regression and the Cuzick test were used to evaluate trends. US Census data were used to generate age- and sex-adjusted national estimates of ICU admissions and costs.ResultsOf 2 157 991 pediatric admissions, 275 656 (12.8%) included ICU care. The mean (SD) age was 6.43 (6.10) years; 121 894 individuals were female (44.2%), and 153 731 were male (55.8%). From 2001 to 2019, the prevalence of ICU care among hospitalized children increased from 10.6% to 15.5%. The percentage of ICU admissions in children’s hospitals rose from 51.2% to 85.1% (relative risk [RR], 1.66; 95% CI, 1.64-1.68). The percentage of children admitted to an ICU with an underlying comorbidity increased from 46.2% to 57.0% (RR, 1.23; 95% CI, 1.22-1.25), and the percentage with preadmission technology dependence increased from 16.4% to 23.5% (RR, 1.44; 95% CI, 1.40-1.48). The prevalence of multiple organ dysfunction syndrome increased from 6.8% to 21.0% (RR, 3.12; 95% CI, 2.98-3.26), while mortality decreased from 2.5% to 1.8% (RR, 0.72; 95% CI, 0.66-0.79). Hospital length of stay increased by 0.96 days (95% CI, 0.73-1.18) for ICU admissions from 2001 to 2019. After inflation adjustment, total costs for a pediatric admission involving ICU care nearly doubled between 2001 and 2019. Nationally, an estimated 239 000 children were admitted to a US ICU in 2019, corresponding to $11.6 billion in hospital costs.Conclusions and RelevanceIn this study, the prevalence of children receiving ICU care in the US increased, as did length of stay, technology use, and associated costs. The US health care system must be equipped to care for these children in the future.

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Functional Outcomes and Physical Impairments in Pediatric Critical Care Survivors: A Scoping Review*

Cited by 132 publications

References 104 publications

Long-Term Function After Pediatric Critical Illness: Results From the Survivor Outcomes Study*

Long-Term Function After Pediatric Critical Illness: Results From the Survivor Outcomes Study*

Morbidity

Epidemiology of Intensive Care Admissions for Children in the US From 2001 to 2019

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