Quality of life of survivors of paediatric intensive care
Related Experiment Videos
Julia Ambuehl1, Adrienne Karrer, Andreas Meer
1Paediatric and Neonatal Intensive Care Unit, University Children's Hospital, Inselspital, Bern, Switzerland.
Insights
Most children survive paediatric intensive care with a good long-term outcome. However, overall mortality doubles within two years post-discharge, highlighting the need for continued monitoring of paediatric intensive care unit survivors.
Area of Science:
- Pediatric Critical Care Medicine
- Quality of Life Research
- Long-term Health Outcomes
Background:
- Paediatric intensive care unit (PICU) mortality rates have declined.
- Advanced treatments are used for critically ill children.
- Assessing long-term outcomes and quality of life (QoL) post-PICU is crucial.
Purpose of the Study:
- To evaluate the long-term quality of life and survival of children after PICU discharge.
- To identify factors influencing outcomes in PICU survivors.
Main Methods:
- Prospective follow-up study of 661 patients admitted to a 12-bed PICU in 2001.
- Telephone interviews conducted 1 and 2 years post-discharge.
- Quality of life assessed using the health state classification (HSC) index across four domains.
Main Results:
- In-unit mortality was 3.9%; 2-year post-discharge mortality was 3.2% (total 6.4%).
- 77% of survivors had a good outcome (HSC 1.0-0.7) at 2 years.
- Patients with respiratory, neurological, or medical admissions had better outcomes than those with cardiovascular disease or postoperative care needs.
Conclusions:
- The majority of paediatric intensive care unit survivors experience a good long-term quality of life.
- Overall mortality risk increases significantly within two years of discharge from paediatric intensive care.
Objective:
The mortality rate in paediatric intensive care units (PICU) has fallen over the last two decades. More advanced treatment is offered to children with life-threatening disease and there is substantial interest in knowing whether long term outcome and quality of life after intensive care are acceptable.
Setting:
12-bed paediatric and neonatal intensive care unit.
Intervention:
Prospective follow-up study with telephone interview 1 and 2 years after discharge.
Methods:
Four domains of quality of life (physical function, role function, social-emotional function and health problem) were recorded by calculating the health state classification (HSC) index. Outcome was classified good (HSC 1.0-0.7), moderate (HSC 0.69-0.3), poor (HSC 0.29-0) and very poor (HSC <0).
Results:
661 patients were admitted to the PICU in the year 2001 with a mortality within the unit of 3.9%. Over 2 years follow-up there were 21 additional deaths (3.2%). 574 patients could be followed up after 1 year and 464 patients after 2 years. After two years the outcome was good in 77%, moderate in 15% and poor in 8%. Patients with respiratory disease had the best outcome, similar to those admitted for neurological and medical reasons. Patients admitted for postoperative care and for cardiovascular disease had a poorer quality of life. 31% of the children had preexisting health care problems and 21% of all patients had new chronic disease after intensive care.
Conclusion:
The majority of survivors admitted to the PICU have a good outcome. The overall mortality rate doubled if assessed two years after discharge.
Related Concept Videos
01:20Acute Kidney Injury V: Interprofessional Care
01:30Pneumonia III: Complications and Assessment
01:17Classification of Illness
An illness is a response to a disease in which the person's level of functioning is changed compared with a previous level. The general classification of illness includes acute and chronic.
Acute illness is severe and...