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Health-related quality of life after prolonged pediatric intensive care unit stay*

Conlon, Niamh P. FCARCSI; Breatnach, Cormac MRCPI(Paeds); O’Hare, Brendan P. MRCPI, FFARCSI; Mannion, David W. FFARCSI; Lyons, Barry J. FFARCSI

Pediatric Critical Care Medicine: January 2009 - Volume 10 - Issue 1 - p 41-44
doi: 10.1097/PCC.0b013e31819371f6
Feature Articles

Objective: To investigate the long-term health-related quality of life (HRQOL) outcomes for patients requiring at least 28 days of pediatric intensive care.

Design: Retrospective cohort and prospective follow-up study.

Setting: A 21-bed pediatric intensive care unit (PICU) in a university-affiliated, tertiary referral pediatric hospital.

Patients: One hundred ninety-three patients who spent 28 days or longer in the PICU between January 1, 1997 and December 31, 2004.

Interventions: Quality of life was measured using the Pediatric Quality of Life Inventory (Peds QL 4.0) parent-proxy version at 2 to 10 yrs after discharge. The PedsQL 4.0 is a modular measure of HRQOL, which is reliable in children aged 2 to 18 yrs. It generates a total score and physical, emotional, social, school, and psychosocial subscores.

Measurements and Main Results: Of the 193 patients, 41 died during their PICU admission and 27 died between PICU discharge and follow-up. Quality of life questionnaires were posted to parents of 108 of the 125 survivors and 70 were returned completed. Forty children (57.1%) had scores indicating a normal quality of life, whereas 30 (42.9%) had scores indicating impaired HRQOL. Of these, 14 (20%) had scores indicating poor quality of life with ongoing disabling health problems requiring hospitalization or the equivalent.

Conclusions: Our results indicate that, while long PICU stay is associated with significant mortality, the long-term HRQOL is normal for the majority of surviving children.

From the Department of Anaesthesia and Intensive Care Medicine, Our Lady’s Hospital for Sick Children, Crumlin Road, Crumlin, Dublin, Ireland.

The first two authors should be considered joint first authors.

The authors have not disclosed any potential conflict of interest.

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©2009The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies