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儿科重症监护病房幸存者:长期结局研究中影响可行性和队列保留率的因素

PICU Survivorship: Factors Affecting Feasibility and Cohort Retention in a Long-Term Outcomes Study.

作者信息

Sobotka Sarah A, Lynch Emma J, Dholakia Ayesha V, Mayampurath Anoop, Pinto Neethi P

机构信息

Section of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, 950 East 61st Street, Suite 207, Chicago, IL 60637, USA.

Department of Pediatrics, Boston Children's Hospital, Boston, MA 02115, USA.

出版信息

Children (Basel). 2022 Jul 13;9(7):1041. doi: 10.3390/children9071041.

Abstract

Our understanding of longitudinal outcomes of Pediatric Intensive Care Unit (PICU) survivors is limited by the heterogeneity of follow-up intervals, populations, and outcomes assessed. We sought to demonstrate (1) the feasibility of longitudinal multidimensional outcome assessment and (2) methods to promote cohort retention. The objective of this presented study was to provide details of follow-up methodology in a PICU survivor cohort and not to present the outcomes at long-term follow-up for this cohort. We enrolled 152 children aged 0 to 17 years admitted to the PICU in a prospective longitudinal cohort study. We examined resource utilization, family impact of critical illness, and neurodevelopment using the PICU Outcomes Portfolio (POP) Survey which included a study-specific survey and validated tools: 1. Functional Status Scale, 2. Pediatric Evaluation of Disability Inventory Computer Adaptive Test, 3. Pediatric Quality of Life Inventory, 4. Strengths and Difficulties Questionnaire, and 5. Vanderbilt Assessment Scales for Attention Deficit-Hyperactivity Disorder. POP Survey completion rates were 89%, 78%, and 84% at 1, 3, and 6 months. Follow-up rates at 1, 2, and 3 years were 80%, 55%, and 43%. Implementing a longitudinal multidimensional outcome portfolio for PICU survivors is feasible within an urban, tertiary-care, academic hospital. Our attrition after one year demonstrates the long-term follow-up challenges in this population. Our findings inform ongoing efforts to implement core outcome sets after pediatric critical illness.

摘要

我们对儿科重症监护病房(PICU)幸存者纵向结局的理解受到随访间隔、人群和评估结局的异质性限制。我们试图证明(1)纵向多维结局评估的可行性以及(2)促进队列留存的方法。本研究的目的是提供PICU幸存者队列随访方法的详细信息,而非呈现该队列长期随访的结局。在一项前瞻性纵向队列研究中,我们纳入了152名年龄在0至17岁之间入住PICU的儿童。我们使用PICU结局组合(POP)调查来检查资源利用、危重病对家庭的影响以及神经发育情况,该调查包括一项特定研究的调查和经过验证的工具:1. 功能状态量表;2. 残疾儿童评估量表计算机自适应测试;3. 儿童生活质量量表;4. 长处与困难问卷;5. 注意缺陷多动障碍范德比尔特评估量表。POP调查在1个月、3个月和6个月时的完成率分别为89%、78%和84%。1年、2年和3年时的随访率分别为80%、55%和43%。在城市三级医疗学术医院内,为PICU幸存者实施纵向多维结局组合是可行的。我们1年后的失访情况表明了该人群长期随访面临的挑战。我们的研究结果为儿科危重病后实施核心结局集的持续努力提供了参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3dd/9317147/9437da401c07/children-09-01041-g001.jpg

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