An investigation into the relationship between risk of mortality on admission to a paediatric intensive care unit and health related quality of life at six month follow-up in the United Kingdom

Objectives: The aim of the study is to investigate the relationship between risk of mortality at admission to a paediatric intensive care unit (PICU) and health status at six months post discharge from PICU in the United Kingdom (UK). Patients and Methods: Prospective follow-up study of children aged 6 months or more at admission to PICU between 2001 and 2002, who were discharged alive. Health status was measured using the Health Utility Index Mark II (HUI2). Risk of mortality was measured using the Paediatric Index of Mortality (PIM and PIM2) and the Pediatric Risk of Mortality (PRISM and PRISM III). The relationship between H U 12 outcomes (individual dimensions and overall Disability) and mortality risk measures was investigated using generalised ordered regression, adjusted for PICUs effect. Results: Eighty six percent (1221/1414) of children had complete data on all HUI2 dimensions. Nearly two thirds (803/1221) of the children had moderate to severe disability. PIM was significantly associated with disability. The odds ratio of having none/mild vs. moderate or severe disability was 1.4, 95% Cl 1.2 to 1.7 for each unit increase in log PIM. More than three quarters of children with severe disability were correctly classified by PIM with good discrimination (c-index = 0.60, p-value < 0.001). PIM also showed a significant relationship to the following individual HUl2 dimensions: Sensation, Mobility, Emotion, Cognition, Self-care, and Pain. Conclusions: Mortality risk tools may be adequate for predicting mortality as outcome following admission to PICU, but of these only PIM showed the potential for predicting long term health status in these children based on c-index and misclassification rate.EThOS - Electronic Theses Online ServiceGBUnited Kingdo