Post-intensive-care morbidity among pediatric patients in Thailand: prevalence, risk factors, and the importance of the post-intensive-care clinic

泰国儿科患者重症监护后并发症:患病率、危险因素及重症监护后门诊的重要性

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Abstract

BACKGROUND: Long-term survival data for critically ill children discharged to post-intensive care clinics are scarce, especially in Asia. The main objective of this study was to assess the prevalence of post-intensive-care morbidity among pediatric intensive care unit (PICU) survivors at 1 month and 1 year after hospital discharge and to identify the associated risk factors. METHODS: We conducted a retrospective chart review of all children aged 1 month to 15 years who were admitted to the PICU for >48 hours from July 2019 to July 2022 and visited a post-intensive-care clinic 1 month and 1 year after hospital discharge. Post-intensive care morbidity was defined using the Pediatric Cerebral Performance Category (PCPC). Descriptive statistics, univariate, and multivariate analyses were conducted. RESULTS: A total of 111 children visited the clinic at 1 month, and 100 of these children visited the clinic at 1 year. Only 39 of 111 children (35.2%) had normal PCPC assessments at 1 month, while 54 of 100 (54.0%) were normal at 1 year. Baseline developmental delays were significantly associated with any degree of disability and at least moderate disability at both time points. Mechanical ventilation for >7 days was associated with at least moderate disability at both time points, while PICU stay >7 days was significantly associated with moderate disability at 1 month and any degree of disability at 1 year. CONCLUSIONS: A substantial percentage of PICU survivors had persistent disabilities even 1 year after critical illness. A structured multidisciplinary post-intensive-care follow-up plan is warranted to provide optimal care for such children.

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