Long-term functional outcomes of children after critical illnesses: A cohort study

Abstract

ObjectiveTo assess children's functional outcomes one year after critical illness and identify which factors influenced these functional outcomes. DesignAmbispective cohort study. SettingPediatric intensive care unit (PICU) in a tertiary academic center. ParticipantsChildren (1 month–17-year-old) and their caregivers. InterventionsNone. Main variables of interestDemographic, clinical, and functional status. ResultsOf 242 patients screened, 128 completed the year follow-up. These children had significant changes in functional status over time (p<0.001). The functional decline occurred in 62% of children at discharge and, after one year, was persistent in 33%. Age>12 months was a protective factor against poor functional outcomes in two regression models (p<0.05). A moderately abnormal functional status and a severely/very severely abnormal functional status at discharge increased the risks of poor functional outcomes by 4.14 (95% CI 1.02–16.72; p=0.04), and 4.76 (CI 95% 1.19–19.0; p=0.02). A functional decline at discharge increased by 6.86 (95%CI: 2.16-21.79; p=0.001) the risks of children's long-term poor functional outcomes, regardless of the FSS scores. ConclusionThis is the first study evaluating long-term functional outcomes after pediatric critical illnesses in Latin America. Our findings show baseline data and raise relevant questions for future multicentre studies in this field in Latin America, contributing to a better understanding of the effects of critical illnesses on long-term functional outcomes in children.