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An explorative study on quality of life and psychological and cognitive function in pediatric survivors of septic
Madelon B Bronner1, Hendrika Knoester, Jeanine J Sol
1Psychosocial Department, Pediatric Intensive Care Unit, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands.
Insights
Pediatric septic shock survivors reported quality of life and mental health comparable to norms. However, cognitive function was significantly lower, particularly in younger children admitted to the pediatric intensive care unit.
Area of Science:
- Pediatric critical care medicine
- Neuropsychology
- Quality of life research
Background:
- Septic shock is a life-threatening condition in children, with potential long-term consequences.
- Understanding the health-related quality of life (HRQoL), anxiety, depression, and cognitive function of survivors is crucial for comprehensive care.
- Previous research has not fully elucidated these outcomes in pediatric septic shock survivors.
Purpose of the Study:
- To evaluate self-reported HRQoL, anxiety, depression, and cognitive function in pediatric septic shock survivors.
- To compare these outcomes to age-related norm populations.
- To identify factors associated with cognitive problems in this cohort.
Main Methods:
- Retrospective cohort study conducted in a tertiary pediatric intensive care unit.
- Included children aged 8 years or older at follow-up, admitted between 1995 and 2004 for septic shock requiring inotropic/vasoconstrictive agents for at least 24 hours.
- Assessed HRQoL (KIDSCREEN-52), anxiety (State Trait Anxiety Inventory for Children), depression (Children's Depression Inventory), and cognitive function (TNO-AZL Children's Quality of Life Questionnaire Child Form).
Main Results:
- Fifty of 82 eligible survivors were evaluated, with a median age of 10.7 years at follow-up.
- HRQoL and anxiety scores were comparable to Dutch norm populations.
- Depression scores were significantly better than norms, but cognitive function was significantly lower (44% had scores <25% of norm). Younger age at pediatric intensive care unit admission predicted cognitive problems, which were linked to lower emotional function.
Conclusions:
- Pediatric septic shock survivors exhibit HRQoL, anxiety, and depression levels similar to or better than age-related norms.
- Cognitive function is notably decreased, with younger admission age being a significant risk factor.
- Further longitudinal studies with comprehensive neuropsychological assessments are needed to understand the long-term cognitive impact of pediatric septic shock and associated risk factors.
Objective:
To evaluate self-reported health-related quality of life, anxiety, depression, and cognitive function in pediatric septic shock survivors.
Design:
A retrospective cohort study.
Setting:
A 14-bed tertiary pediatric intensive care unit.
Patients:
Children aged >or=8 yrs at the time of the follow-up who were admitted between 1995 and 2004 for septic shock. Inotropic and or vasoconstrictive agents were administered to these patients for >or=24 hrs.
Intervention:
Health-related quality of life was assessed with the KIDSCREEN-52, anxiety with the State Trait Anxiety Inventory for Children, depression with the Children's Depression Inventory, and cognitive function with the cognitive scale of the TNO-AZL Children's Quality of Life Questionnaire Child Form.
Measurements And Main Results:
Fifty of 82 eligible pediatric septic shock survivors were evaluated. The median age of the children at pediatric intensive care unit admission was 4.2 yrs (range, 0.0-17.0 yrs); the median age at follow-up was 10.7 yrs (range, 8.0-20.4 yrs). Health-related quality of life and anxiety scores were comparable to the age-related Dutch norm population. Depression scores were significantly better than the norm population, whereas cognitive function was significantly lower than the norm population. We found that 44% of the children had cognitive scores <25% of the norm population. Young age at the time of pediatric intensive care unit admission was predictive of cognitive problems, and cognitive problems were associated with lower emotional function.
Conclusions:
In this group of septic shock survivors, health-related quality of life, anxiety, and depression are equal to or slightly better than the age-related Dutch norm population. Cognitive function is decreased, especially in children admitted at younger ages. Follow-up studies with adequate neuropsychological testing are warranted to evaluate the association between septic shock, cognitive function, and risk factors for cognitive problems.