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Published on: November 20, 2015
Neurodevelopmental and Behavioral Outcomes in Children With Sepsis-Associated Encephalopathy Admitted to Pediatric
Jasmine Kaur1, Pratibha Singhi2, Sunit Singhi1
1Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Children with sepsis-associated encephalopathy (SAE) show significant neurodevelopmental delays and behavioral issues. SAE impacts cognitive functions, leading to lower IQ scores and school performance decline in affected children.
Area of Science:
- Pediatric Neurology
- Intensive Care Medicine
- Developmental Psychology
Background:
- Sepsis-associated encephalopathy (SAE) is a serious complication in critically ill children.
- Neurodevelopmental and behavioral outcomes following SAE require further investigation.
Purpose of the Study:
- To compare neurodevelopmental and behavioral outcomes in children with SAE versus healthy controls.
- To identify factors associated with poor outcomes in children with SAE.
Main Methods:
- Prospective comparison of 50 children with SAE and healthy controls.
- Assessment of neurodevelopmental (IQ, General Development Score) and behavioral outcomes.
- Analysis of Glasgow Coma Scale scores and clinical factors.
Main Results:
- Children with SAE exhibited significantly lower verbal IQ, full-scale IQ, and General Development Scores.
- SAE group showed higher prevalence of low intelligence (52% vs 32%) and behavioral changes like school performance decline (44%).
- Lower Glasgow Coma Scale scores correlated with full-scale IQ impairments, while irritability, shock, and sedation duration impacted behavioral outcomes.
Conclusions:
- SAE is associated with short-term neurodevelopmental delays, including low verbal IQ and impaired cognitive function.
- Behavioral issues, particularly decline in school performance, are common sequelae of SAE.
- Clinical factors like irritability, shock, and sedation duration are linked to adverse behavioral outcomes in children with SAE.
Abstract:
The authors prospectively compared the neurodevelopmental and behavioral outcomes in 50 consecutive children with sepsis-associated encephalopathy admitted to intensive care unit with healthy controls. Children with sepsis-associated encephalopathy had significantly worse mean verbal IQ, full-scale IQ, General Development Score, and its physical, adaptive, social-emotional, cognitive, and communication subscales. Significant proportion of cases (52% vs 32% in controls) had low intelligence. Decline in school performance (44%), disobedience (28%), and stubbornness/irritable behavior (26%) were the most common behavior changes. Children with Glasgow Coma Scale score ≤10 and ≤8 had impairments in full-scale IQ even though overall Glasgow Coma Scale score did not show significant correlation with developmental outcomes. In conclusion, children with sepsis-associated encephalopathy have delayed neurodevelopment, low verbal IQ, decline in school performance and low intelligence at short-term follow-up. Irritability, shock and duration of sedation are associated with poor behavioral outcomes, especially scholastic performance.
