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Functional evaluation of pediatric patients after discharge from the intensive care unit using the Functional Status
Gabriela Alves Pereira1,2, Camila Wohlgemuth Schaan3, Renata Salatti Ferrari3
1Universidade Federal de Ciências da Saúde de Porto Alegre - Porto Alegre (RS), Brasil.
Insights
Pediatric intensive care unit (PICU) survivors show moderate functional impairment post-discharge, particularly in motor and feeding abilities. Readmitted patients experienced worse outcomes and higher mortality risk.
Area of Science:
- Pediatric critical care medicine
- Rehabilitation medicine
- Patient outcomes research
Background:
- Pediatric intensive care unit (PICU) survivors often face long-term functional deficits.
- Assessing functional status post-PICU is crucial for recovery and readmission risk.
- The Functional Status Scale (FSS) is a tool for evaluating pediatric functional impairment.
Purpose of the Study:
- To assess the functional status of pediatric patients after PICU discharge using the FSS.
- To compare functional impairment with mechanical ventilation duration, PICU length of stay, and mortality risk (Pediatric Index of Mortality 2).
Main Methods:
- Cross-sectional study of 50 patients post-PICU discharge.
- Functional status evaluated using the FSS on day 1 post-discharge.
- Pediatric Index of Mortality 2 used for mortality prediction at PICU admission.
Main Results:
- Overall FSS score indicated moderate impairment (median 11.5).
- Highest impairment in "motor function" and "feeding" domains.
- Readmitted patients had worse FSS scores across multiple domains and higher Pediatric Index of Mortality 2 scores.
Conclusions:
- PICU discharge functional status is moderately impaired, especially in motor and feeding domains.
- Readmission is associated with poorer functional outcomes and increased mortality risk.
- Greater functional impairment correlates with longer mechanical ventilation and PICU hospitalization.
Objective:
To evaluate the functional status of pediatric patients after discharge from the pediatric intensive care unit using the Functional Status Scale and to compare the time of invasive mechanical ventilation, length of stay in the pediatric intensive care unit, and Pediatric Index of Mortality 2 results among individuals with different degrees of functional impairment.
Methods:
A cross-sectional study was conducted on patients who were discharged from a pediatric intensive care unit. The functional evaluation by the Functional Status Scale was performed on the first day after discharge from the unit, and the Pediatric Index of Mortality 2 was used to predict the mortality rate at the time of admission to the pediatric intensive care unit.
Results:
The sample consisted of 50 individuals, 60% of which were male, with a median age of 19 [6 - 61] months. The overall score of the Functional Status Scale was 11.5 [7 - 15], and the highest scores were observed in the "motor function" 3 [1 - 4] and "feeding" 4 [1 - 4] domains. Compared to patients who were not readmitted to the pediatric intensive care unit, patients who were readmitted presented a worse overall score (p = 0.01), worse scores in the "motor function" (p = 0.01), "feeding" (p = 0.02), and "respiratory" (p = 0.036) domains, and a higher mortality rate according to the Pediatric Index of Mortality 2 (p = 0.025).
Conclusion:
Evaluation of the functional status using the Functional Status Scale indicated moderate impairment in patients after discharge from the pediatric intensive care unit, mainly in the "motor function" and "feeding" domains; patients who were readmitted to the pediatric intensive care unit demonstrated worse overall functional, motor function, feeding and respiratory scores. Individuals with greater functional impairment had longer times of invasive mechanical ventilation and hospitalization in the pediatric intensive care unit.
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