Qualidade de vida relacionada à saúde de sobreviventes à terapia intensiva pediátrica

Abstract

Objectives

To assess the health-related quality of life (HRQoL) of children surviving to pediatric intensive care discharge.

Methods

A prospective evaluation of HRQoL at admission and 6 months later was carried out with children aged 6 years or more, admitted to three tertiary pediatric intensive care units (PICUs) from May 2002 to June 2004. HRQoL was measured with the Health Utilities Index Mark 3 (HUI3) questionnaire, administered to a child’s proxy.

Results

From the 517 eligible admissions, 44 children died in the PICU (8.5%) and 320 cases were evaluated at admission; among those, follow-up data were available in 252 cases. There were no statistically differences between preadmission and follow-up HUI3 global scores (medians [interquartile range] of 0.86 [0.42-1.00] and 0.83 [0.45-1.00]; p = 0.674, respectively). At individual level, 21% of children had their HRQoL unchanged, improvement was seen in 40% and deterioration in 38% of the cases. Severe disability before admission (HUI3 global score < 0.70) was present in 36% of the cases, with improvement at the 6-month follow-up in 60% of them. Among those with deterioration of HRQoL at follow-up, 45% were trauma victims.

Conclusions

Although the HRQoL was globally similar in both evaluations, several differences were found at individual level. Children with low preadmission HRQoL (severe disability) may benefit from pediatric intensive care, since many of these children improved their HRQoL compared to preadmission status.