Pediatric Critical Care-Associated Parental Traumatic Stress: Beyond the First Year

Area of Science:

• Pediatric Critical Care Medicine
• Psychotraumatology
• Parental Mental Health

Background:

• Pediatric intensive care unit (PICU) admission is a significant stressor for parents.
• Parental mental health outcomes, particularly posttraumatic stress disorder (PTSD), following PICU discharge require further investigation.

Purpose of the Study:

• To conduct a longitudinal analysis of parental traumatic stress up to 30 months after PICU discharge.
• To identify risk factors associated with the development and persistence of parental PTSD.

Main Methods:

• Prospective observational cohort study involving parents of children admitted to tertiary care PICUs.
• Utilized the PTSD Symptom Scale Interview for DSM-5 to assess PTSD symptoms at 3-9 and 18-30 months post-discharge.
• Employed multivariable analysis to identify predictors of parental PTSD.

Main Results:

• At 3-9 months, 14.8% of parents met PTSD criteria. Risk factors included acute stress disorder (ASD), child's severe neurological status, concerns about permanent injury, and increased knowledge of illness.
• At 18-30 months, 12.5% of parents met PTSD criteria. Risk factors included ASD, family history of ICU admission, and concerns about child's mortality.
• Parents with PTSD at 18-30 months were more likely to report decreased household income.

Conclusions:

• Parental PTSD is a significant, persistent morbidity following PICU admission for a subset of parents.
• Identifiable risk factors, such as ASD and family history of ICU admission, can inform targeted interventions.
• Longitudinal assessment is vital for understanding the trajectory and impact of parental PTSD after PICU discharge.