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Educational Outcomes of Childhood Survivors of Critical Illness—A Population-Based Linkage Study*

Major postintensive care sequelae affect up to one in three adult survivors of critical illness. Large cohorts on educational outcomes after pediatric intensive care are lacking. We assessed primary school educational outcomes in a statewide cohort of children who survived PICU during childhood. DES...

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Autores principales: Tomaszewski, Wojtek, Ablaza, Christine, Straney, Lahn, Taylor, Catherine, Millar, Johnny, Schlapbach, Luregn J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112965/
https://www.ncbi.nlm.nih.gov/pubmed/35170536
http://dx.doi.org/10.1097/CCM.0000000000005461
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author Tomaszewski, Wojtek
Ablaza, Christine
Straney, Lahn
Taylor, Catherine
Millar, Johnny
Schlapbach, Luregn J.
author_facet Tomaszewski, Wojtek
Ablaza, Christine
Straney, Lahn
Taylor, Catherine
Millar, Johnny
Schlapbach, Luregn J.
author_sort Tomaszewski, Wojtek
collection PubMed
description Major postintensive care sequelae affect up to one in three adult survivors of critical illness. Large cohorts on educational outcomes after pediatric intensive care are lacking. We assessed primary school educational outcomes in a statewide cohort of children who survived PICU during childhood. DESIGN: Multicenter population-based study on children less than 5 years admitted to PICU. Using the National Assessment Program—Literacy and Numeracy database, the primary outcome was educational achievement below the National Minimum Standard (NMS) in year 3 of primary school. Cases were compared with controls matched for calendar year, grade, birth cohort, sex, socioeconomic status, Aboriginal and Torres Strait Islander status, and school. Multivariable logistic regression models to predict educational outcomes were derived. SETTING: Tertiary PICUs and mixed ICUs in Queensland, Australia. PATIENTS: Children less than 5 years admitted to PICU between 1998 and 2016. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: Year 3 primary school data were available for 5,017 PICU survivors (median age, 8.0 mo at first PICU admission; interquartile range, 1.9–25.2). PICU survivors scored significantly lower than controls across each domain (p < 0.001); 14.03% of PICU survivors did not meet the NMS compared with 8.96% of matched controls (p < 0.001). In multivariate analyses, socioeconomic status (odds ratio, 2.14; 95% CI, 1.67–2.74), weight (0.94; 0.90–0.97), logit of Pediatric Index of Mortality-2 score (1.11; 1.03–1.19), presence of a syndrome (11.58; 8.87–15.11), prematurity (1.54; 1.09–2.19), chronic neurologic conditions (4.38; 3.27–5.87), chronic respiratory conditions (1.65; 1.24–2.19), and continuous renal replacement therapy (4.20; 1.40–12.55) were independently associated with a higher risk of not meeting the NMS. CONCLUSIONS: In this population-based study of childhood PICU survivors, 14.03% did not meet NMSs in the standardized primary school assessment. Socioeconomic status, underlying diseases, and severity on presentation allow risk-stratification to identify children most likely to benefit from individual follow-up and support.
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spelling pubmed-91129652022-05-25 Educational Outcomes of Childhood Survivors of Critical Illness—A Population-Based Linkage Study* Tomaszewski, Wojtek Ablaza, Christine Straney, Lahn Taylor, Catherine Millar, Johnny Schlapbach, Luregn J. Crit Care Med Feature Articles Major postintensive care sequelae affect up to one in three adult survivors of critical illness. Large cohorts on educational outcomes after pediatric intensive care are lacking. We assessed primary school educational outcomes in a statewide cohort of children who survived PICU during childhood. DESIGN: Multicenter population-based study on children less than 5 years admitted to PICU. Using the National Assessment Program—Literacy and Numeracy database, the primary outcome was educational achievement below the National Minimum Standard (NMS) in year 3 of primary school. Cases were compared with controls matched for calendar year, grade, birth cohort, sex, socioeconomic status, Aboriginal and Torres Strait Islander status, and school. Multivariable logistic regression models to predict educational outcomes were derived. SETTING: Tertiary PICUs and mixed ICUs in Queensland, Australia. PATIENTS: Children less than 5 years admitted to PICU between 1998 and 2016. INTERVENTIONS: Not applicable. MEASUREMENTS AND MAIN RESULTS: Year 3 primary school data were available for 5,017 PICU survivors (median age, 8.0 mo at first PICU admission; interquartile range, 1.9–25.2). PICU survivors scored significantly lower than controls across each domain (p < 0.001); 14.03% of PICU survivors did not meet the NMS compared with 8.96% of matched controls (p < 0.001). In multivariate analyses, socioeconomic status (odds ratio, 2.14; 95% CI, 1.67–2.74), weight (0.94; 0.90–0.97), logit of Pediatric Index of Mortality-2 score (1.11; 1.03–1.19), presence of a syndrome (11.58; 8.87–15.11), prematurity (1.54; 1.09–2.19), chronic neurologic conditions (4.38; 3.27–5.87), chronic respiratory conditions (1.65; 1.24–2.19), and continuous renal replacement therapy (4.20; 1.40–12.55) were independently associated with a higher risk of not meeting the NMS. CONCLUSIONS: In this population-based study of childhood PICU survivors, 14.03% did not meet NMSs in the standardized primary school assessment. Socioeconomic status, underlying diseases, and severity on presentation allow risk-stratification to identify children most likely to benefit from individual follow-up and support. Lippincott Williams & Wilkins 2022-02-16 2022-06 /pmc/articles/PMC9112965/ /pubmed/35170536 http://dx.doi.org/10.1097/CCM.0000000000005461 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Feature Articles
Tomaszewski, Wojtek
Ablaza, Christine
Straney, Lahn
Taylor, Catherine
Millar, Johnny
Schlapbach, Luregn J.
Educational Outcomes of Childhood Survivors of Critical Illness—A Population-Based Linkage Study*
title Educational Outcomes of Childhood Survivors of Critical Illness—A Population-Based Linkage Study*
title_full Educational Outcomes of Childhood Survivors of Critical Illness—A Population-Based Linkage Study*
title_fullStr Educational Outcomes of Childhood Survivors of Critical Illness—A Population-Based Linkage Study*
title_full_unstemmed Educational Outcomes of Childhood Survivors of Critical Illness—A Population-Based Linkage Study*
title_short Educational Outcomes of Childhood Survivors of Critical Illness—A Population-Based Linkage Study*
title_sort educational outcomes of childhood survivors of critical illness—a population-based linkage study*
topic Feature Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9112965/
https://www.ncbi.nlm.nih.gov/pubmed/35170536
http://dx.doi.org/10.1097/CCM.0000000000005461
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