Related Experiment Video
Updated: Mar 8, 2026
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Long-Term Function After Pediatric Critical Illness: Results From the Survivor Outcomes Study
Neethi P Pinto1, Elizabeth W Rhinesmith, Tae Yeon Kim
11Department of Pediatrics, The University of Chicago, Chicago, IL. 2Department of Pediatrics, Children's National Medical Center, Washington, DC. 3Pritzker School of Medicine, The University of Chicago, Chicago, IL.
Insights
Pediatric critical illness survivors face increasing mortality and morbidity post-discharge. Long-term outcomes reveal a sustained impact on survival and functional status.
Area of Science:
- Pediatric Critical Care Medicine
- Long-term Health Outcomes
- Patient Survival and Morbidity
Background:
- Limited data exists on the long-term outcomes for survivors of pediatric critical illness.
- Understanding post-discharge health trajectories is crucial for comprehensive patient care.
Purpose of the Study:
- To evaluate morbidity and mortality at 6 months and 3 years following hospital discharge in pediatric intensive care unit (PICU) survivors.
- To identify factors associated with long-term functional outcomes after critical illness.
Main Methods:
- A prospective cohort study was conducted in an urban, academic pediatric intensive care unit.
- Functional status was assessed using the Functional Status Scale, with new morbidity defined as a score change ≥3.
- Post-discharge assessments involved scripted telephone surveys at 6 months and 3 years.
Main Results:
- Cumulative mortality increased from 3.9% at discharge to 10.4% at 3 years (p=0.03).
- New morbidity rose from 5.2% at discharge to 10.4% at 3 years (p=0.16).
- Combined poor outcomes (mortality and new morbidity) increased significantly from 9.1% at discharge to 20.8% by 3 years (p=0.01).
Conclusions:
- Mortality and new morbidity rates substantially increase after hospital discharge in pediatric critical illness survivors.
- Pediatric critical illness has a sustained negative impact on both survival and functional status in the long term.
Objective:
Knowledge of the long-term outcomes of survivors of pediatric critical illness is sparse but important. The aim of this study was to evaluate morbidity and mortality 6 months and 3 years after hospital discharge.
Design:
Prospective cohort study.
Setting:
Urban, inner city, academic PICU.
Patients:
Consecutive patients admitted to the PICU from June 2012 to August 2012.
Interventions:
None.
Measurements And Main Results:
We collected descriptive and demographic information and functional status assessments at baseline, admission, hospital discharge, 6 months and 3 years following discharge. Functional status was measured with the Functional Status Scale. New morbidity was defined as a change in Functional Status Scale score of greater than or equal to 3. Postdischarge assessments utilized scripted telephone surveys. Of 303 consecutive PICU patients, 253 were eligible and 129 parents consented. Follow-up outcomes were obtained for 77 patients (59.7%) at 6 months and 70 of these patients (54.2%) at 3 years. Both mortality and morbidity increased after discharge. Cumulative mortality increased from 3.9% (n = 3) at discharge to 7.8% (n = 6) at 6 months (p = 0.08) and 10.4% (n = 8) at 3 years (p = 0.03). New morbidity increased cumulatively from 5.2% (n = 4) at discharge to 6.5% (n = 5) at 6 months (p = 0.65) and 10.4% (n = 8) at 3 years (p = 0.16). Almost as many children demonstrated worsening of their functional status or died (38%) as children who survived without a change in functional status (44%). Less than 10% of children exhibited functional gains over time. Long-term functional outcome was associated with PICU variables including the need for invasive therapies and indicators of severity of illness such as use of mechanical ventilation, ventilator days, use of vasoactive medications, and PICU length of stay. The combined poor outcomes of new morbidity and mortality increased cumulatively from 9.1% (n = 7) at discharge to 14.3% (n = 11) at 6 months (p = 0.16) and 20.8% (n = 16) by 3 years (p = 0.01).
Conclusions:
Mortality and new morbidity appear to substantially increase after discharge. Critical illness is associated with a sustained impact on survival and functional status.
Related Concept Videos
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...
01:29Acute Kidney Injury III: Clinical Manifestations
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:16Kidney Transplant III: Nursing Management
01:30Acute Respiratory Failure-III