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Intelligence outcome of pediatric intensive care unit survivors: a systematic meta-analysis and meta-regression

Eleonore S V de Sonnaville1,2, Marsh Kӧnigs3, Ouke van Leijden3

  • 1Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Department of Pediatric Intensive Care, Amsterdam Reproduction and Development research institute, Meibergdreef 9, Amsterdam, The Netherlands. e.s.desonnaville@amsterdamumc.nl.

BMC Medicine
|June 1, 2022
PubMed

Insights

Pediatric intensive care unit (PICU) survivors show lower intelligence scores compared to controls. Factors like longer PICU stays and female sex are linked to greater impairment, with outcomes worsening over time.

Area of Science:

  • Pediatric critical care medicine
  • Neurodevelopmental outcomes
  • Intelligence assessment

Background:

  • Long-term morbidity following pediatric intensive care unit (PICU) admission is a significant concern.
  • Critical illness and PICU treatments can impact neurocognitive development, particularly intelligence.
  • This study addresses the need to quantify intelligence outcomes and identify risk factors for impairment.

Purpose of the Study:

  • To quantify intelligence outcomes in pediatric intensive care unit (PICU) survivors compared to controls.
  • To explore demographic and clinical risk factors associated with impaired intelligence post-PICU admission.
  • To analyze intelligence outcomes across various PICU subgroups.

Main Methods:

  • A systematic search of PubMed, Embase, CINAHL, and PsycINFO databases was conducted.
  • Random-effects meta-analysis was used to compare full-scale intelligence quotient (FSIQ) between PICU survivors and controls.
  • Meta-regression analysis investigated the relationship between risk factors and FSIQ effect sizes.

Main Results:

  • PICU survivors (n=8,119) exhibited significantly lower FSIQ scores (0.47 SD or 7.1 IQ-points) compared to controls (n=1,757).
  • All PICU subgroups showed reduced FSIQ scores, with impairment ranging from 0.38 to 0.88 SD.
  • Later admission year and longer PICU stay correlated with greater FSIQ impairment; male sex and higher survival rates were associated with less impairment.

Conclusions:

  • Pediatric intensive care unit (PICU) survivors across various subgroups are at risk for intelligence impairment.
  • Longer PICU stays, female sex, and lower survival rates are associated with greater intelligence deficits.
  • Intelligence outcomes have deteriorated over time, possibly reflecting increased survival rates in critically ill children.
Abstract

Keywords:
ChildrenCognitiveDevelopmentIQIntelligenceMeta-analysisMeta-regressionOutcomePediatric intensive care

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