Functional status of pediatric patients after discharge from intensive care units in a middle-income country.

backgroundPatients discharged from the intensive care unit (ICU) often experience high morbidity rates. The aim of the present study was to estimate the incidence of functional capacity impairment in pediatric patients who were discharged from the ICU in a middle-income country and to identify associated factors, considering the socioeconomic context.

methodsThis was a multicenter cohort study of 357 patients aged <18 years admitted to three ICUs in the interior cities of São Paulo State. The Functional Status Scale was used to assess the patients at admission, ICU discharge, and hospital discharge. New morbidity was defined as a change in any domain of the scale equal to or greater than two, or a change in the total score equal to or greater than three. A multiple logistic regression model was used to identify independent associations with new morbidity.

resultsNew morbidity occurred in 14.6% and 12.3% of patients at ICU and hospital discharge, respectively, compared with those at admission. The feeding (p < 0.001) and respiratory (p = 0.036) functional domains were the most affected at ICU discharge. The risk factors associated with new morbidity at hospital discharge were heart disease, older age, longer ICU stay, and higher PELOD2 severity score.

conclusionsTo reduce the risk of new functional morbidity, healthcare teams should be attentive to the critically ill pediatric population, particularly those who are older and have chronic clinical conditions, especially heart disease.