An explorative study on quality of life and psychological and cognitive function in pediatric survivors of septic shock.
OBJECTIVE
To evaluate self-reported health-related quality of life, anxiety, depression, and cognitive function in pediatric septic shock survivors.


METHODS
A retrospective cohort study.


METHODS
A 14-bed tertiary pediatric intensive care unit.


METHODS
Children aged >or=8 yrs at the time of the follow-up who were admitted between 1995 and 2004 for septic shock. Inotropic and or vasoconstrictive agents were administered to these patients for >or=24 hrs.


METHODS
Health-related quality of life was assessed with the KIDSCREEN-52, anxiety with the State Trait Anxiety Inventory for Children, depression with the Children's Depression Inventory, and cognitive function with the cognitive scale of the TNO-AZL Children's Quality of Life Questionnaire Child Form.


RESULTS
Fifty of 82 eligible pediatric septic shock survivors were evaluated. The median age of the children at pediatric intensive care unit admission was 4.2 yrs (range, 0.0-17.0 yrs); the median age at follow-up was 10.7 yrs (range, 8.0-20.4 yrs). Health-related quality of life and anxiety scores were comparable to the age-related Dutch norm population. Depression scores were significantly better than the norm population, whereas cognitive function was significantly lower than the norm population. We found that 44% of the children had cognitive scores <25% of the norm population. Young age at the time of pediatric intensive care unit admission was predictive of cognitive problems, and cognitive problems were associated with lower emotional function.


CONCLUSIONS
In this group of septic shock survivors, health-related quality of life, anxiety, and depression are equal to or slightly better than the age-related Dutch norm population. Cognitive function is decreased, especially in children admitted at younger ages. Follow-up studies with adequate neuropsychological testing are warranted to evaluate the association between septic shock, cognitive function, and risk factors for cognitive problems.
Bronner
Madelon B
MB
Psychosocial Department, Pediatric Intensive Care Unit, Emma Children's Hospital, Academic Medical Center, Amsterdam, Netherlands.
Knoester
Hendrika
H
Sol
Jeanine J
JJ
Bos
Albert P
AP
Heymans
Hugo S A
HS
Grootenhuis
Martha A
MA
D000223:Adaptation, Psychological; D000293:Adolescent; D000367:Age Factors; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D012772:Shock, Septic / Q000150:complications / Q000523:psychology*; D017741:Survivors / Q000523:psychology*