Surviving meningococcal septic shock in childhood: long-term overall outcome and the effect on health-related quality of life

Abstract

IntroductionThe purpose of this study was to evaluate associations between long-term physical and psychological outcome variables in patients who survived meningococcal septic shock (MSS) in childhood.MethodsThe study population was made up of all MSS patients requiring intensive care treatment between 1988 and 2001.ResultsA total of 120 patients visited the follow-up clinic (age at paediatric intensive care unit (PICU) admission 3.1 years; follow-up interval 9.8 years; age at follow-up 14.5 years (all medians)). Four major outcomes were considered: 1) major physical sequelae (defined as major scars and/or orthopaedic sequelae) (29/120), 2) mild neurological impairments (39/120), 3) problem behaviour (defined as a total score above the 90th percentile of the reference groups on questionnaires to screen for psychopathology) (16/114) and 4) total intelligence quotient < 85 (18/115). No differences were found between patients with major physical sequelae and patients without major physical sequelae as to the presence of problem behaviour or total IQ < 85. Also, no differences were found between patients with mild neurological impairments and patients without as to the presence of problem behaviour or total IQ < 85. Finally, no differences were found between patients with major physical sequelae and patients without as to the presence of mild neurological sequelae. Less favourable scores on behavioural and emotional problems were significantly associated with poorer health-related quality of life (HR-QoL). HR-QoL scores were to a lesser amount predicted by severity of illness at time of PICU admission or by adverse physical outcome.ConclusionsLong-term adverse physical and psychological outcomes in survivors of MSS did not seem to be associated. Poorer HR-QoL was mainly predicted by problem behaviour.

Syndromes of Self-Reported Psychopathology for Ages 18–59 in 29 Societies

“…It can be completed in 15–20 min on paper, online, or in interviews. The ASR and its predecessor, the Young Adult Self-Report (YASR; Achenbach 1997), have been used in over 100 published studies with foci such as prospective follow-ups (van der Ende et al 2012); treatment outcomes (Saavedra et al 2010); molecular genetics (Boomsma et al 2008); quantitative genetics (Forsman et al 2010); and special populations (Buysse et al 2010). …”

Primary Outcome Measures in Pediatric Septic Shock Trials: A Systematic Review*

“…While none of the trials in our study included HRQL measures and only one trial assessed functional outcomes, evidence supports the importance of evaluating long-term outcomes for children and families who have survived critical illness (43–46). While these outcomes are clinically relevant and more patient centered (47), there is presently no consensus on how best to measure functional status or HRQL, the timing of these measurements and how interventions in pediatric septic shock may impact functional recovery.…”

A Baby With Meningococcemia and Septic Shock

“…One PICU staff member (CB) who ran a follow-up clinic for all meningococcal septic shock survivors stressed that long-term health-related quality of life was not associated with physical outcome variables like amputation in these patients. 4 Her studies showed that, after a life-threatening illness such as meningococcal septic shock, many parents and patients reported a greater appreciation of life. Some felt that the event had made them stronger and that they tried to make the best of their lives.…”