title: Surviving meningococcal septic shock in childhood: long-term overall outcome and the effect on health-related quality of life.
abstract: BACKGROUND
  The purpose of this study was to evaluate associations between long-term physical and psychological outcome variables in patients who survived meningococcal septic shock (MSS) in childhood.
  
  
  METHODS
  The study population was made up of all MSS patients requiring intensive care treatment between 1988 and 2001.
  
  
  RESULTS
  A total of 120 patients visited the follow-up clinic (age at paediatric intensive care unit (PICU) admission 3.1 years; follow-up interval 9.8 years; age at follow-up 14.5 years (all medians)). Four major outcomes were considered: 1) major physical sequelae (defined as major scars and/or orthopaedic sequelae) (29/120), 2) mild neurological impairments (39/120), 3) problem behaviour (defined as a total score above the 90th percentile of the reference groups on questionnaires to screen for psychopathology) (16/114) and 4) total intelligence quotient < 85 (18/115). No differences were found between patients with major physical sequelae and patients without major physical sequelae as to the presence of problem behaviour or total IQ < 85. Also, no differences were found between patients with mild neurological impairments and patients without as to the presence of problem behaviour or total IQ < 85. Finally, no differences were found between patients with major physical sequelae and patients without as to the presence of mild neurological sequelae. Less favourable scores on behavioural and emotional problems were significantly associated with poorer health-related quality of life (HR-QoL). HR-QoL scores were to a lesser amount predicted by severity of illness at time of PICU admission or by adverse physical outcome.
  
  
  CONCLUSIONS
  Long-term adverse physical and psychological outcomes in survivors of MSS did not seem to be associated. Poorer HR-QoL was mainly predicted by problem behaviour.
authors.affiliation: Department of Paediatrics, Division of Paediatric Intensive Care, Erasmus MC-Sophia Children's Hospital, Dr Molewaterplein 60, Rotterdam 3015 GJ, The Netherlands. c.buysse@erasmusmc.nl
authors.forename: Corinne M P
authors.initials: CM
authors.lastname: Buysse
authors.forename: Lindy C A C
authors.initials: LC
authors.lastname: Vermunt
authors.forename: Hein
authors.initials: H
authors.lastname: Raat
authors.forename: Jan A
authors.initials: JA
authors.lastname: Hazelzet
authors.forename: Wim C J
authors.initials: WC
authors.lastname: Hop
authors.forename: Elisabeth M W J
authors.initials: EM
authors.lastname: Utens
authors.forename: Koen F M
authors.initials: KF
authors.lastname: Joosten
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000150:complications* / Q000276:immunology; D011788:Quality of Life; D012772:Shock, Septic / Q000209:etiology / Q000276:immunology*; D016019:Survival Analysis