Functional status of pediatric patients after discharge from intensive care units in a middle-income country

Area of Science:

• Pediatric critical care medicine
• Functional outcomes research
• Public health in middle-income countries

Background:

• Intensive care unit (ICU) survivors, particularly children, often experience significant morbidity post-discharge.
• Functional capacity impairment is a common and serious complication following pediatric critical illness.
• Understanding incidence and risk factors is crucial for improving post-ICU care in resource-limited settings.

Purpose of the Study:

• To determine the incidence of new functional capacity impairment in pediatric patients after ICU discharge in a middle-income country.
• To identify factors associated with functional decline in this vulnerable population.
• To inform targeted interventions for preventing post-ICU morbidity.

Main Methods:

• Multicenter cohort study involving 357 pediatric patients across three ICUs.
• Functional Status Scale assessed at admission, ICU discharge, and hospital discharge.
• Multiple logistic regression analysis to identify independent predictors of new morbidity.

Main Results:

• New functional morbidity was observed in 14.6% at ICU discharge and 12.3% at hospital discharge.
• Feeding and respiratory domains were most frequently affected at ICU discharge.
• Independent risk factors for new morbidity included heart disease, older age, prolonged ICU stay, and higher pediatric severity scores.

Conclusions:

• Critically ill children are at high risk for new functional morbidity after ICU discharge.
• Older children and those with pre-existing conditions like heart disease require heightened clinical attention.
• Proactive monitoring and targeted interventions are essential to mitigate functional decline in pediatric ICU survivors.