Long-Term Follow-Up of Daily Life Functioning After Pediatric Intensive Care Unit Admission

Abstract

To investigate the long-term impact of pediatric intensive care unit (PICU) admission on daily life functioning while exploring the potential mediating role of neurocognitive outcome. This cross-sectional observational study compared children aged 6-12years with previous PICU admission (age ≤1year) for bronchiolitis requiring mechanical ventilation ("patient group," n=65) to demographically comparable healthy peers ("control group," n=76). The patient group was selected because bronchiolitis is not expected to affect neurocognitive functioning in itself. Assessed daily life outcome domains were behavioral and emotional functioning, academic performance, and health-related quality of life (QoL). The role of neurocognitive outcomes in the relationship between PICU admission and daily life functioning was assessed by mediation analysis. The patient group did not differ from the control group regarding behavioral and emotional functioning but performed poorer on academic performance and school-related QoL (Ps≤.04, d=-0.48 to -0.26). Within the patient group, lower full-scale IQ (FSIQ) was associated with poorer academic performance and school-related QoL (Ps≤.02). Poorer verbal memory was associated with poorer spelling performance (P=.002). FSIQ mediated the observed effects of PICU admission on reading comprehension and arithmetic performance. Children admitted to the PICU are at risk for long-term adverse daily life outcomes in terms of academic performance and school-related QoL. Findings suggest that lower intelligence may contribute to academic difficulties after PICU admission. Findings underline the importance of monitoring daily life and neurocognitive functioning after PICU admission.