BACKGROUND: After a critical disease many complications could appear, one of them is functional impairment. OBJECTIVES: To evaluate the functional status of critical pediatric patients after hospital discharge. MATERIALS AND METHODS: Prospective longitudinal observational study, included 214 patients with age between one month and <18 years old, who needed PICU admission. The functional status was evaluated with Functional Status Scale (FSS-Brazil) at baseline, PICU discharge, hospital discharge, three and six months after this and new morbidity was defined as a worsening in functional status in the FSS-Brazil of two or more points in the same domain compared with the baseline score. The Generalized Estimating Equation model was used to compare the FSS-Brazil scores. McNemar Chi-square test was used to evaluate the difference between the categories of functional status in each domain. Poisson regression was performed to determine associations between clinical variables and functional status. RESULTS: Of the 214 patients, 135 finished the follow-up. The majority of the sample was males (57.5%), with some chronic condition (76.2%) and 45.8% were readmitted to the hospital. It was observed moderate dysfunction in FSS-Brazil score (10-15) at PICU discharge (42.1%) and the new morbidity was observed in 11.5% of the sample after hospital discharge. More days in invasive mechanical ventilation increases 1.02 the risk of new morbidity. CONCLUSIONS: Patients who needed PICU recovered functional status after hospital discharge and remained stable in three and six months. The incidence of new morbidity was low and invasive mechanical ventilation was a risk factor for new morbidity.
MEASUREMENTS AND MAIN RESULTS:We evaluated the following: clinical and sociodemographic characteristics, functional status using the Functional Status Scale-Brazil (FSS-Brazil) at baseline and at hospital discharge, and hospital readmission within 1 year. Hospital readmission risk was associated with possible related factors using Cox regression to estimate the hazard ratio (HR). A total of 196 patients completed the follow-up. At hospital discharge, 39.3% of children had some degree of decline in FSS-Brazil, and 38.3% had at least one nonelective hospital readmission within 1 year. FSS-Brazil rating at hospital discharge was associated with the risk of hospital readmission within 1 year (HR, 1.698; 95% CI, 1.016-2.838).CONCLUSION: FSS-Brazil rating at hospital discharge, age, and length of stay were associated with greater hazard of nonelective hospital readmission within 1 year of discharge.
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