Table 4.
Predictors of Health-Related Quality of Life (ITQOL) in Young Children Six Months After PICU Discharge (n = 352)
| Covariates | Overall health OR (95% CI) | Physical abilities β (95% CI) | Growth and development β (95% CI) | Pain and discomfort β (95% CI) | Temperament and moods β (95% CI) | General health β (95% CI) |
|---|---|---|---|---|---|---|
| Income quartiles (ref = High) | ||||||
| Low | 0.6 (0.3, 1.0) | −8.6* (−15.5, −1.8) | −0.8 (−5.1, 3.5) | 8.2* (2.9, 13.5) | −4.3* (−7.1, −1.4) | 1.1 (−3.2, 5.4) |
| Low Middle | 0.7 (0.4, 1.1) | 3.8 (−3.1, 10.8) | 1.7 (−2.0, 5.5) | 0.7 (−3.3, 4.7) | −0.98 (−3.8, 1.8) | −0.8 (−6.4, 4.8) |
| High Middle | 0.6 (0.3, 1.1) | 2.7 (−4.5, 9.9) | −2.6 (−6.4, 1.1) | 0.02 (−5.4, 5.5) | −1.6 (−5.1, 1.8) | −3.4 (−8.1, 1.2) |
| Age at follow-up (ref = <1yr) | ||||||
| 1yr to <2yr | 0.9 (0.6, 1.1) | −0.8 (−7.1, 5.6) | −1.8 (−5.9, 2.3) | 2.3 (−1.6, 6.2) | 0.3 (−2.6, 3.2) | −2.0 (−5.3, 1.3) |
| 2yr to <6yr | 0.4 (0.2, 1.0) | −7.9 (−29.4, 13.6) | −4.0 (−14.8, 6.8) | −3.8 (−16.1, 8.5) | −2.5 (−8.2, 3.1) | −4.0 (−12.0, 4.0) |
| Preexisting condition | 0.5* (0.3, 0.9) | −6.6 (−18.9, 5.7) | −4.9 (−11.4, 1.6) | 3.1 (−3.5, 9.7) | −0.9 (−5.0, 3.1) | −5.5 (−11.1, 0.1) |
| PARDS on day 0/1a (ref = at risk/mild) | ||||||
| Moderate | 0.7 (0.4, 1.2) | 1.6 (−4.3, 7.4) | −2.2 (−6.6, 2.3) | 0.02 (−5.5, 5.5) | −1.8 (−4.6, 1.0) | −3.0 (−7.8, 1.6) |
| Severe | 0.9 (0.6, 1.5) | −0.5 (−9.6, 8.6) | −1.6 (−7.5, 4.3) | −1.9 (−6.0, 2.3) | −3.5* (−6.2, −0.8) | −3.3 (−6.6, −0.05) |
| Organ system dysfunctionb | 1.03 (0.8, 1.3) | 1.8 (−0.7, 4.3) | 2.1* (0.2, 3.9) | 1.1 (−0.6, 2.9) | 0.4 (−0.7, 1.5) | −0.007 (−1.5, 1.4) |
| Duration of mechanical ventilation, per day | 0.97 (0.9, 1.03) | −0.4 (−0.97, 0.2) | −0.2 (−0.6, 0.3) | 0.1 (−0.5, 0.6) | 0.04 (−0.2, 0.3) | −0.3 (−0.6, 0.05) |
| Functional status at discharge (ref = age-appropriate) | ||||||
| Mild disability | 0.3 (0.1, 1.2) | −16.4 (−33.7, 0.9) | −13.5* (−21.8, −5.2) | −4.0 (−14.3, 6.3) | −0.3 (−6.7, 6.1) | −6.0 (−16.9, 4.9) |
| Moderate disability | 0.2** (0.1, 0.5) | −18.9** (−27.8, −10.0) | −22.6** (−33.1, −12.2) | 1.6 (−5.7, 8.8) | −2.2 (−7.9, 3.6) | −13.2** (−20.7, −5.8) |
| Severe disability or vegetative state | 0.2** (0.1, 0.5) | −44.5** (−66.8, −22.1) | −26.8* (−42.8, −10.8) | −9.9 (−24.1, 4.4) | −10.0* (−19.3, −0.7) | −12.3* (−21.5, −3.1) |
Abbreviations: PICU, pediatric intensive care unit; OR, odds ratio; CI, confidence interval; PARDS, pediatric acute respiratory distress syndrome. Higher scores indicate better health-related quality of life.
*
P < .05
**
P < .001
a
PARDS severity was defined using the 2015 Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria. (33)
b
Organ system dysfunction was measured continuously; every subject had respiratory dysfunction and dysfunction in up to five additional organ systems. (34)