(871) Evaluating Post-Intensive Care Syndrome in Pediatrics in a Community Children’s Hospital

Introduction: The primary aim of this study was to demonstrate that neurocognitive follow-up is feasible in a community children’s hospital pediatric intensive care unit (PICU) population. The secondary objectives were to describe PICU survivors acquired morbidities and characterize recommended follow-up interventions.

Methods:

Design: Retrospective cohort study
Setting: A 24-bed PICU within a community children’s hospital
Patients: Children (ages 1 day to 18 years) admitted to the PICU between January 1, 2013 to December 31, 2023 who were evaluated in the pediatric neuropsychology outpatient clinic within 6 months of hospital discharge.

Results: Among 343 children, 806 neuropsychology outpatient appointments occurred. 21% children had an inpatient neuropsychology assessment whereas 79% of children had an initial outpatient assessment followed by a feedback session. Most commonly, children had 2 appointments but some required longitudinal follow-up: 11.7% children had 4, 2.3% children had 6, and 0.3% children had 8 total appointments. Medical interventions such as referrals to physical, occupational, and speech therapy, psychiatry, psychotherapy, and neurology were recommended for 73.8% of children. Home interventions to address sleep and mood disturbances were recommended for 73.2% children. Academic interventions including suggesting new IEP services, modifications to existing IEPs, and provision of additional time to complete tasks were recommended for 76.1% children.

Conclusions: Neurocognitive follow-up is feasible after pediatric critical illness, indicating PICU survivors experience significant functional and psychosocial morbidities after hospital discharge. Post-PICU follow-up is necessary to screen for these problems and provide medical, home, and academic interventions to optimize long-term outcomes.