Health-related quality of life for pediatric emergency department febrile illnesses: an evaluation of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales.
OBJECTIVE
We sought to assess the validity and short-term responsiveness of the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL) for febrile illnesses evaluated in the pediatric emergency department (ED).


METHODS
Prospective cohort study of children 2-18 years discharged after ED evaluation for fever (>or= 38 degrees C). Self-administered, parent-report of health-related quality of life (HRQOL) was assessed using the PedsQL Acute Version, a validated HRQOL instrument. HRQOL was measured on ED presentation and at 7-10 day follow-up. At follow-up, duration of fever, child functional impairment, missed daycare/school, and disrupted family unit functioning, were assessed.


RESULTS
Of 160 subjects enrolled, 97 (61%) completed the study; mean follow-up was 8.7 days. Mean total HRQOL score on ED presentation was 76.4; mean follow-up score was 86.3. Compared to subjects that returned to baseline, statistically significant differences in HRQOL were noted for those with prolonged fever, child functional impairment, and relapse. Significant correlation was observed between HRQOL at follow-up and days of daycare/school missed (r = -0.35, p = .003) and days of family disruption (r = -0.43, p < .001). Mean change in HRQOL within subjects, from ED visit to follow-up, was +9.8 (95% CI: 5.6-14.6). Effect size was 0.53, indicating moderate responsiveness.


CONCLUSIONS
The PedsQL appears to be a valid and responsive indicator of HRQOL for short-term febrile illnesses evaluated in the ED.
Mistry
Rakesh D
RD
Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. mistryr@email.chop.edu
Stevens
Molly W
MW
Gorelick
Marc H
MH
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D004632:Emergency Medical Services; D005260:Female; D005334:Fever; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D010372:Pediatrics; D011594:Psychometrics; D011788:Quality of Life