(745) Neurodevelopmental Monitoring in Recovery From Pediatric Disorders of Consciousness

Introduction: Coma and disorders of consciousness (DOC) have been studied for decades with the focus primarily on adults, but it can be difficult for clinicians to remodel the adult definitions for children. There is a PCPC (Pediatric Cerebral Performance Category) and POPC (Pediatric Overall Performance Category) score, which measure basic developmental capabilities that are age-appropriate, that some pediatric intensive care unit (PICU) providers will use to document functional levels on PICU admission and discharge. We aim to investigate the predictive nature of these scores on neurodevelopment recovery from PICU admission with a DOC.

Methods: Retrospective chart review was performed. Subjects were recruited based on the inclusion criteria of being aged 0-21 of both genders and have been patients admitted to the PICU with a DOC between January 2016 to January 2021. POPC and PCPC scores based on standardized assessments were collected as continuous variables. Data analysis was conducted using chi square likelihood ratios to identify how variances among admission and discharge POPC and PCPC scores are associated with better or worse outcomes.

Results: A total of 290 patients between the ages of 0-21 were admitted to the PICU with a DOC from 2016-2021 with ICD codes consistent with any type of DOC. There were 159 male and 131 female patients. A Pearson Chi-Square test was performed to evaluate the predictive nature of POPC scores at admission and discharge, and PCPC scores at admission and discharge, which resulted in a likelihood ratio (LR) of 46.7 (p < 0.001) and a LR of 42.9 (p < 0.002), respectively. Independent two-sided t-test was performed assessing equality of means of duration of PICU stay with admission POPC scores, with equal variances not assumed, which was not significant (p < 0.067).

Conclusions: Our results demonstrate that POPC scores on admission to the PICU have a clinically significant predictive power on POPC and PCPC scores on discharge in patients with DOC. The scores on admission can help the providers better understand the anticipated neurodevelopmental outcome for the patient on discharge and more routine scores could help us characterize the patient’s residual deficits and nature of their DOC to better anticipate their neurodevelopmental trajectory of recovery.