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Health-Related Quality of Life After Community-Acquired Septic Shock in Children With Preexisting Severe Developmental Disabilities.
Pediatr Crit Care Med. 2021 05 01; 22(5):e302-e313.PC

Abstract

OBJECTIVES

To serially evaluate health-related quality of life during the first year after community-acquired septic shock in children with preexisting severe developmental disabilities and explore factors associated with health-related quality of life changes in these children.

DESIGN

Secondary analysis of the Life after Pediatric Sepsis Evaluation investigation.

SETTING

Twelve academic PICU in the United States.

PATIENTS

Children greater than or equal to 1 month and less than 18 years old identified by their family caregiver (e.g., parent/guardian) as having severe developmental disability prior to septic shock.

INTERVENTIONS

Family caregivers completed the Stein-Jessop Functional Status II-R Short Form as a measure of their child's health-related quality of life at baseline (reflecting preadmission status), day 7, and months 1, 3, 6, and 12 following PICU admission. Stein-Jessop Functional Status II-R Short Form scores were linearly transformed to a 0-100 scale, with higher scores indicating better health-related quality of life.

MEASUREMENTS AND MAIN RESULTS

Of 392 Life after Pediatric Sepsis Evaluation participants, 137 were identified by their caregiver as having a severe developmental disability. Sixteen children (11.6%) with severe disability died during the 12 months following septic shock. Among 121 survivors, Stein-Jessop Functional Status II-R Short Form scores declined from preadmission baseline to day 7 (70.7 ± 16.1 vs 55.6 ± 19.2; p < 0.001). Stein-Jessop Functional Status II-R Short Form scores remained below baseline through month 12 (59.1 ± 21.0, p < 0.001 vs baseline). After adjusting for baseline Stein-Jessop Functional Status II-R Short Form, the caregiver being a single parent/guardian was associated with lower month 3 Stein-Jessop Functional Status II-R Short Form scores (p = 0.041). No other baseline child or caregiver characteristic, or critical illness-related factors were significantly associated with month 3 Stein-Jessop Functional Status II-R Short Form scores.

CONCLUSIONS

Health-related quality of life among children with severe developmental disability remains, on average, below baseline during the first year following community-acquired septic shock. Children with severe disability and septic shock that are in single parent families are at increased risk. Clinical awareness of the potential for decline in health-related quality of life among disabled children is essential to prevent this adverse outcome from being missed.

Authors+Show Affiliations

Department of Pediatrics, Children's Hospital of Michigan, Central Michigan University, Detroit, MI.Department of Pediatrics, University of Utah, Salt Lake City, UT.Department of Pediatrics, Children's Hospital of Colorado, University of Colorado School of Medicine, Aurora, CO.Department of Pediatrics, University of Utah, Salt Lake City, UT.Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA.Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA.Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH.Department of Pediatrics, C.S. Mott Children's Hospital, University of Michigan, Ann Arbor, MI.Department of Critical Care Medicine, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA.Department of Pediatrics, Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA.Department of Pediatrics, Children's Hospital of Colorado, University of Colorado School of Medicine, Aurora, CO.Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.Department of Pediatrics, University of Utah, Salt Lake City, UT.Department of Pediatrics, University of Utah, Salt Lake City, UT.Center for Child Health, Behavior and Development, Seattle Children's Hospital, Seattle Research Institute, Seattle, WA.Department of Pediatrics, University of Utah, Salt Lake City, UT.Department of Pediatrics, Seattle Children's Hospital, Seattle Research Institute, University of Washington School of Medicine, Seattle, WA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

33156209

Citation

Meert, Kathleen L., et al. "Health-Related Quality of Life After Community-Acquired Septic Shock in Children With Preexisting Severe Developmental Disabilities." Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, vol. 22, no. 5, 2021, pp. e302-e313.
Meert KL, Reeder RW, Maddux AB, et al. Health-Related Quality of Life After Community-Acquired Septic Shock in Children With Preexisting Severe Developmental Disabilities. Pediatr Crit Care Med. 2021;22(5):e302-e313.
Meert, K. L., Reeder, R. W., Maddux, A. B., Banks, R., Berg, R. A., Newth, C. J., Hall, M. W., Quasney, M., Carcillo, J. A., McQuillen, P. S., Mourani, P. M., Chima, R. S., Holubkov, R., Sorenson, S., McGalliard, J., Dean, J. M., & Zimmerman, J. J. (2021). Health-Related Quality of Life After Community-Acquired Septic Shock in Children With Preexisting Severe Developmental Disabilities. Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 22(5), e302-e313. https://doi.org/10.1097/PCC.0000000000002606
Meert KL, et al. Health-Related Quality of Life After Community-Acquired Septic Shock in Children With Preexisting Severe Developmental Disabilities. Pediatr Crit Care Med. 2021 05 1;22(5):e302-e313. PubMed PMID: 33156209.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Health-Related Quality of Life After Community-Acquired Septic Shock in Children With Preexisting Severe Developmental Disabilities. AU - Meert,Kathleen L, AU - Reeder,Ron W, AU - Maddux,Aline B, AU - Banks,Russell, AU - Berg,Robert A, AU - Newth,Christopher J, AU - Hall,Mark W, AU - Quasney,Michael, AU - Carcillo,Joseph A, AU - McQuillen,Patrick S, AU - Mourani,Peter M, AU - Chima,Ranjit S, AU - Holubkov,Richard, AU - Sorenson,Samuel, AU - McGalliard,Julie, AU - Dean,J Michael, AU - Zimmerman,Jerry J, AU - ,, AU - ,, PY - 2022/05/01/pmc-release PY - 2020/11/7/pubmed PY - 2021/5/20/medline PY - 2020/11/6/entrez SP - e302 EP - e313 JF - Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies JO - Pediatr Crit Care Med VL - 22 IS - 5 N2 - OBJECTIVES: To serially evaluate health-related quality of life during the first year after community-acquired septic shock in children with preexisting severe developmental disabilities and explore factors associated with health-related quality of life changes in these children. DESIGN: Secondary analysis of the Life after Pediatric Sepsis Evaluation investigation. SETTING: Twelve academic PICU in the United States. PATIENTS: Children greater than or equal to 1 month and less than 18 years old identified by their family caregiver (e.g., parent/guardian) as having severe developmental disability prior to septic shock. INTERVENTIONS: Family caregivers completed the Stein-Jessop Functional Status II-R Short Form as a measure of their child's health-related quality of life at baseline (reflecting preadmission status), day 7, and months 1, 3, 6, and 12 following PICU admission. Stein-Jessop Functional Status II-R Short Form scores were linearly transformed to a 0-100 scale, with higher scores indicating better health-related quality of life. MEASUREMENTS AND MAIN RESULTS: Of 392 Life after Pediatric Sepsis Evaluation participants, 137 were identified by their caregiver as having a severe developmental disability. Sixteen children (11.6%) with severe disability died during the 12 months following septic shock. Among 121 survivors, Stein-Jessop Functional Status II-R Short Form scores declined from preadmission baseline to day 7 (70.7 ± 16.1 vs 55.6 ± 19.2; p < 0.001). Stein-Jessop Functional Status II-R Short Form scores remained below baseline through month 12 (59.1 ± 21.0, p < 0.001 vs baseline). After adjusting for baseline Stein-Jessop Functional Status II-R Short Form, the caregiver being a single parent/guardian was associated with lower month 3 Stein-Jessop Functional Status II-R Short Form scores (p = 0.041). No other baseline child or caregiver characteristic, or critical illness-related factors were significantly associated with month 3 Stein-Jessop Functional Status II-R Short Form scores. CONCLUSIONS: Health-related quality of life among children with severe developmental disability remains, on average, below baseline during the first year following community-acquired septic shock. Children with severe disability and septic shock that are in single parent families are at increased risk. Clinical awareness of the potential for decline in health-related quality of life among disabled children is essential to prevent this adverse outcome from being missed. SN - 1529-7535 UR - https://www.unboundmedicine.com/medline/citation/33156209/Health_Related_Quality_of_Life_After_Community_Acquired_Septic_Shock_in_Children_With_Preexisting_Severe_Developmental_Disabilities_ L2 - https://doi.org/10.1097/PCC.0000000000002606 DB - PRIME DP - Unbound Medicine ER -