O056 / #552: A SCOPING REVIEW: ESSENTIAL OUTCOME DOMAINS IN PEDIATRIC CRITICAL CARE AND THE INSTRUMENTS USED TO EVALUATE THEM

Aims & Objectives: Assessing morbidities after pediatric critical illness is imperative to evaluate practice and improve patient and family outcomes. We conducted a scoping review to identify the medical literature describing the domains and instruments used to evaluate these morbidities.

Methods: We queried PubMEd, EMBASE, Cumulative Index of Nursing and Allied Health Literature, Cochrane Controlled Trials Registry, and PyschInfo for studies evaluating pediatric critical care survivors or their families published 1970-2017. We identified articles using key words related to critical illness and 7 domains (overall health, emotional, physical, cognitive, health-related quality of life, social, family). We excluded articles if the majority of patients were >18-years or < 1-month-old, mortality was the sole outcome, or if only instrument psychometrics or procedural outcomes were reported. We used dual review for data extraction and report descriptive statistics.

Results: Of 59,975 citations, 408 articles met inclusion criteria; 87% published after 2000. Studies included observational (85%), interventional (7%), qualitative (5%), and mixed methods (3%). Populations most frequently evaluated were traumatic brain injury (n=96), congenital heart disease (n=72), and general PICU (n=88) populations. Family members were evaluated in 81 (20%) studies. Studies used a median 2 [IQR 1-4] instruments and evaluated a median 2 [IQR 1-3] domains. Social, cognitive and overall health domains were most frequently studied (n=223, 183, and 161, respectively). Across all studies, individual domains were evaluated using a median 48 [IQR 43-76] instruments. (Figure 1)

Conclusions: Pediatric critical care outcomes research methodology is variable. Development of assessment standards will improve understanding and care of critically-ill children and their families.