Long-term health status in childhood survivors of meningococcal septic shock.
OBJECTIVE
To assess long-term health status in patients who survived meningococcal septic shock in childhood.


METHODS
Medical and psychological follow-up of a cross-sectional cohort.


METHODS
Pediatric intensive care unit (PICU) of a tertiary care university hospital.


METHODS
All consecutive patients with septic shock and purpura who required intensive care between 1988 and 2001. Intervention Patients and their parents were invited to our follow-up clinic 4 to 16 years after PICU discharge.


METHODS
Health status was assessed with a standard medical interview, physical examination, renal function test, and the Health Utilities Index Mark 2 (HUI2) and 3 (HUI3).


RESULTS
One hundred twenty patients (response rate 71%) participated in the follow-up (median age at PICU admission, 3.1 years; median follow-up interval, 9.8 years; median age at follow-up, 14.5 years). Thirty-five percent of patients had 1 or more of the following neurological impairments: severe mental retardation with epilepsy (3%), hearing loss (2%), chronic headache (28%), and focal neurological signs (6%), like paresis of 1 arm. One of the 16 patients with septic shock-associated acute renal failure at PICU admission showed signs of mild chronic renal failure (glomerular filtration rate, 62 mL/min/1.73 m(2); proteinuria; and hypertension). Scores were significantly lower on nearly all HUI2 and HUI3 attributes compared with Dutch population data, indicating poorer health in these patients.


CONCLUSIONS
In patients who survived meningococcal septic shock in childhood, one-third showed long-term neurological impairments, ranging from mild to severe and irreversible. Patients reported poorer general health as measured by HUI2 and HUI3.
Buysse
Corinne M P
CM
Department of Paediatrics, Division of Paediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. c.buysse@erasmusmc.nl
Raat
Hein
H
Hazelzet
Jan A
JA
Hulst
Jessie M
JM
Cransberg
Karlien
K
Hop
Wim C J
WC
Vermunt
Lindy C A C
LC
Utens
Elisabeth M W J
EM
Maliepaard
Marianne
M
Joosten
Koen F M
KF
D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006305:Health Status Indicators; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008607:Intellectual Disability / Q000209:etiology; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008589:Meningococcal Infections / Q000150:complications / Q000453:epidemiology* / Q000534:rehabilitation; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012772:Shock, Septic / Q000453:epidemiology* / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D017741:Survivors; D013997:Time Factors