Neurodevelopmental and Behavioral Outcomes in Children With Sepsis-Associated Encephalopathy Admitted to Pediatric Intensive Care Unit: A Prospective Case Control Study.
The authors prospectively compared the neurodevelopmental and behavioral outcomes in 50 consecutive children with sepsis-associated encephalopathy admitted to intensive care unit with healthy controls. Children with sepsis-associated encephalopathy had significantly worse mean verbal IQ, full-scale IQ, General Development Score, and its physical, adaptive, social-emotional, cognitive, and communication subscales. Significant proportion of cases (52% vs 32% in controls) had low intelligence. Decline in school performance (44%), disobedience (28%), and stubbornness/irritable behavior (26%) were the most common behavior changes. Children with Glasgow Coma Scale score ≤10 and ≤8 had impairments in full-scale IQ even though overall Glasgow Coma Scale score did not show significant correlation with developmental outcomes. In conclusion, children with sepsis-associated encephalopathy have delayed neurodevelopment, low verbal IQ, decline in school performance and low intelligence at short-term follow-up. Irritability, shock and duration of sedation are associated with poor behavioral outcomes, especially scholastic performance.
Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Jasmine
J
Kaur
Division of Pediatric Neurology and Neurodevelopment, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India doctorpratibhasinghi@gmail.com.
Pratibha
P
Singhi
Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Sunit
S
Singhi
Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Prahbhjot
P
Malhi
Division of Pediatric Neurology and Neurodevelopment, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Arushi Gahlot
AG
Saini
D000367:Age Factors; D000704:Analysis of Variance; D016022:Case-Control Studies; D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D002658:Developmental Disabilities / Q000209:etiology*; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000175:diagnosis / Q000209:etiology; D007361:Intelligence Tests; D015278:Intensive Care Units, Pediatric; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D065166:Sepsis-Associated Encephalopathy / Q000150:complications*; D012720:Severity of Illness Index; D014705:Verbal Behavior
behavioral; neurodevelopmental; pediatric intensive care; sepsis-associated encephalopathy