Published online November 1, 2006
PEDIATRICS Vol. 118 No. 5 November 2006, pp. 2101-2108 (doi:10.1542/peds.2006-1455)

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ARTICLE

Outcome at 6 Months After Admission for Pediatric Intensive Care: A Report of a National Study of Pediatric Intensive Care Units in the United Kingdom

Samantha Jones, BSc^a, Khadija Rantell, MSc^a, Katherine Stevens, MSc^b, Brigitte Colwell, MSc^c, Jane R. Ratcliffe, MB, ChB^d, Philip Holland, MB, ChB^e, Kathy Rowan, DPhil^f, Gareth J. Parry, PhD^g on behalf of the United Kingdom Pediatric Intensive Care Outcome Study Group

^a Health Services Research
^b Health Economics and Decision Science
^c Institute of General Practice, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom
^d Intensive Care Unit, Royal Liverpool Children's Hospital, Liverpool, United Kingdom
^e General Infirmary at Leeds, Leeds, United Kingdom
^f Intensive Care National Audit and Research Centre, London, United Kingdom
^g Department of Medicine, Children's Hospital Boston, Boston, Massachusetts

OBJECTIVE. The goal was to measure, by using the Health Utilities Index, the health status of children 6 months after admission to PICUs in the United Kingdom.

METHODS. All PICUs in the United Kingdom were invited to participate. Children who were 6 months of age at admission and were discharged alive from participating units during a 1-year period were eligible for this study. Children with completed consent forms who had survived to 6 months after admission received the Health Utilities Index questionnaire.

RESULTS. Admission data on 7214 admissions to 22 units were collected between March 2001 and February 2002. Of those patients, 6786 survived to unit discharge, and consent for follow-up contact was obtained for 2642. At 6 months after admission, the mortality rate was estimated at 11.1% and 2034 children were still alive and contactable. Of those children, Health Utilities Index questionnaires were returned by 1455. No impairment was indicated for 767, 951, 940, 919, 962, and 939 children with respect to the Health Utilities Index sensation, cognition, emotion, pain, mobility, and self-care attributes, respectively. The mean ± SE Health Utilities Index utility score was 0.73 ± 0.01, with 397 children (27.3%) in full health.

CONCLUSIONS. Death after pediatric intensive care in the United Kingdom is uncommon, making assessment of health status important. At 6 months after admission, there is significant morbidity. To assess the impact of strategies to improve or to optimize care on longer-term outcomes, standardized collection of data on preexisting comorbidities and illness severity is required.

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Key Words: intensive care • outcome • quality of life • health status

Abbreviations: HUI—Health Utilities Index • PIM—Pediatric Index of Mortality • PRISM—Pediatric Risk of Mortality • PICOS—Pediatric Intensive Care Outcome Study

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Accepted Jul 25, 2006.

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