More than a feeling: understanding function and health related quality of life after pediatric neurocritical illness
| Autor: | Jessica M. Jarvis, Ericka L. Fink |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Health related quality of life
medicine.medical_specialty Neurology Critical Care business.industry media_common.quotation_subject Critical Care and Intensive Care Medicine Article Feeling Quality of Life Medicine Humans Neurology (clinical) Neurosurgery Function (engineering) business Psychiatry Child media_common |
| Zdroj: | Neurocrit Care |
| ISSN: | 1556-0961 |
| Popis: | BACKGROUND: Despite one third of children with acquired brain injury (ABI) experiencing new functional impairments following critical care admission, there is limited research investigating the impact of new functional impairments upon overall health-related quality of life (HRQOL) or among important HRQOL domains. OBJECTIVES: We aimed to investigate the association between new functional impairments, measured by the Functional Status Scale (FSS), and HRQOL in pediatric patients with ABI after critical care. METHODS: We conducted a secondary analysis of a prospective, observational study of 275 children aged 2 months- 18 years with ABI. Primary exposure evaluated was change in FSS from baseline at hospital discharge categorized per prior work (no change; 1-2 point increase; ≥3 point increase). Primary outcome was overall HRQOL 6-months after hospital discharge measured by the Pediatric Quality of Life Inventory (PedsQL) total score. Secondary outcomes were PedsQL domain scores. PedsQL total and domain scores were transformed into age-standardized z-scores for analyses. Multiple linear regression models evaluated the association between FSS change category and HRQOL (overall and domain z-scores) when controlling for demographic and clinical characteristics, and reported as β-coefficients with 95% Confidence Interval (CI). RESULTS: Complete data were analyzed for 195 (71%) children, including 127 with traumatic brain injury. New functional impairment was common with 32 (16%) patients experiencing FSS increases ≥3, 50 (26%) patients with FSS increases of 1-2 points, and 113 (58%) patients with no change from pre-hospital baseline. The majority of children (63%) demonstrated HRQOL ratings ≥1 standard deviation below healthy age-based standards (z-scores ≤−1). Regression models demonstrated older age, female sex, presence of comorbidities, and pre-admission cardiopulmonary resuscitation were all significantly associated with poorer overall HRQOL (all p |
| Databáze: | OpenAIRE |
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