Unidade de Cuidados Intensivos Pediátricos, UAG-MC Hospital S. João, Porto, Portugal.
Pediatr Crit Care Med. 2013 Jan;14(1):e8-15. doi: 10.1097/PCC.0b013e31826012b4.
To determine predictors of change in the health-related quality of life in survivors to pediatric intensive care, based on preadmission health status, demographic characteristics, and physiological variables.
Prospective evaluation of health-related quality of life at PICU admission and after 6 months.
Three PICUs at tertiary hospitals.
Children aged ≥ 6 yrs admitted to the PICUs between May 2002 and June 2004.
Health Utilities Index Mark 3 questionnaire was administered to a child proxy by direct interview at admission and by telephone interview at follow-up.
From the 517 eligible admissions, 44 (8.5%) children died in the PICU and 252 had a follow-up assessment. From a list of 115 analyzed variables, 29 (25%) and 30 (26%) were selected (p < .10) for a multivariable model predicting improvement and deterioration of the health-related quality of life, respectively. In the final models, only mechanical ventilation, preadmission global score of Health Utilities Index Mark 3, and preadmission Health Utilities Index Mark 3 pain attribute were associated with improvement; and main diagnostic group, preadmission Health Utilities Index Mark 3 emotion attribute, and preadmission Health Utilities Index Mark 3 pain attribute were associated with deterioration in the health-related quality of life.
The most common variables used to compute probability of death algorithms were not capable of predicting health-related quality of life in survivors to pediatric intensive care. The preadmission health-related quality of life and trauma admissions are important variables to predict change in the health-related quality of life of children surviving to pediatric intensive care.
基于入院前健康状况、人口统计学特征和生理变量，确定儿科重症监护幸存者健康相关生活质量变化的预测因素。
在儿科重症监护病房入院时和 6 个月后进行健康相关生活质量的前瞻性评估。
三家三级医院的三个儿科重症监护病房。
2002 年 5 月至 2004 年 6 月期间入住儿科重症监护病房的年龄≥6 岁的儿童。
通过直接访谈和电话访谈，由儿童代理在入院时和随访时对健康效用指数标记 3 问卷进行评估。
从 517 例合格入院患者中，44 例（8.5%）在儿科重症监护病房死亡，252 例有随访评估。在分析的 115 个变量列表中，分别选择了 29 个（25%）和 30 个（26%）（p<.10）用于预测健康相关生活质量改善和恶化的多变量模型。在最终模型中，只有机械通气、入院前健康效用指数标记 3 的总体评分和入院前健康效用指数标记 3 的疼痛属性与改善相关；主要诊断组、入院前健康效用指数标记 3 的情绪属性和入院前健康效用指数标记 3 的疼痛属性与健康相关生活质量恶化相关。
用于计算死亡概率算法的最常见变量不能预测儿科重症监护幸存者的健康相关生活质量。入院前健康相关生活质量和创伤入院是预测儿科重症监护幸存者健康相关生活质量变化的重要变量。
