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Nearly 25% of children have decreased quality of life after sepsis

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Almost one-quarter of children who survived community-acquired sepsis experienced significant declines in health-related quality of life, lasting up to 4.5 months after discharge, according to research presented at the 2017 Pediatric Academic Societies Meeting.

“We are just beginning to appreciate the extent to which a hospitalization for a serious illness affect children long after their discharge from the hospital, and that surviving the acute illness and returning home is not the end of the story,” Elizabeth Killien, MD, lead author and pediatric critical care medicine fellow at the University of Washington School of Medicine, told Infectious Diseases in Children. “This research demonstrates that many children continue to struggle with attention span, walking or running, sleep, memory, or finishing school assignments for months after they leave the hospital following a serious infection.”

Elizabeth Killien

To evaluate the frequency and risk of deterioration in those with pediatric community-acquired sepsis, the researchers conducted a retrospective cohort study of (n = 778) children admitted to Seattle Children’s Hospital between 2012 and 2015 whose symptoms met the 2005 consensus sepsis criteria within 4 hours of presentation.

The researchers measured the children’s health-related quality of life (HRQL) for a baseline acquired before admission and 0.5- to 5-month after discharge status by using the Pediatric Quality of Life Inventory measurement model. Patients who did not recuperate within 4.5 quality of life points of their baseline were documented, and both patient and illness qualities and recovery failures compared with baseline scores were analyzed.

Among children included in the analysis, 23.4% failed to recover. This recovery lasted up to 140 days after discharge, with 50% classified as septic shock in failed recovery, 30.3% as severe sepsis and 21.9% as sepsis. Additional risk factors included ICU admission (39.6%), site of infection (blood = 55.6%, CNS = 52.9%), immune compromise (39.6%), Pediatric Medical Complexity Algorithm category (complex chronic = 30.3%), longer length of stay and shorter time to follow-up.

In the context of multivariable regression, failure to recover was associated with septic shock, CNS infection and immune compromise, although those who had longer lengths of hospital stay were associated only with patients not admitted to an ICU.

“This research demonstrated that children with underlying chronic health problems, immune suppression, infections in their blood or brain, and those with the most severe illnesses and longest hospitalizations were most at risk for health-related quality of life declines,” Killien said in an interview. “Identifying that this is a common problem, and knowing which children are most at risk, will allow us to better support children and families after they leave the hospital to help them recover to their previous quality of life.” —by Katherine Bortz.

Reference:

Killien E, et al. Abstract. Presented at: The Pediatric Academic Societies Meeting; May 6-9, 2017; San Francisco, CA.

Disclosure: The researchers report no relevant financial disclosures.