O020 / #442: POST PEDIATRIC NEUROCRITICAL CARE RECOVERY: A WHOLE CHILD AND FAMILY PERSPECTIVE

Aims & Objectives: Assess child and family outcomes post-pediatric intensive care unit (PICU) discharge after neurocritical illness and factors associated with clinically worse outcomes. Methods: This study examined a subset of participants from a randomized controlled trial investigating PICU-based rehabilitation. Thirty-five families of children aged 3–17 years admitted to a PICU for neurocritical illness and with pre-PICU and 6-months post-PICU data were included. Physical, cognitive, emotional/behavioral, and family functioning outcomes were collected via self-report measures. A clinically worse outcome was defined as a reliable change index of +/- 1.96 over 6-months. Univariate logistic regressions assessed predictors of clinically worse outcome. Results: Six-months post-PICU, 70% of the sample had a clinically worse outcome in at least one domain. Most commonly, clinically worse scores were in externalizing behaviors (40%), executive functioning (38%), cognitive function (30%) and internalizing behaviors (30%). Factors associated with clinically worse outcomes at 6-months included: lower pre-PICU functional status with worse cognitive function (Odds radio [OR]=6.66, 95% Confidence interval [CI], 1.05-42.31); disposition to inpatient rehabilitation with less internalizing behaviors (OR=0.15, 95% CI 0.52-0.91); and lower baseline cognitive status (OR=14.16, 95% CI, 1.57-127.59), increased length of PICU stay (OR=1.21, 95% CI, 1.02-1.43), and decrease in functional status at hospital discharge (OR=1.72, 95% CI, 1.03-2.89) with worse motor function. Conclusions: Pediatric neurocritical care survivors and families commonly experienced new impairments in a variety of domains 6-months post-discharge. Results highlight the need for comprehensive assessments and follow-up to inform care coordination and rehabilitation across hospital to home settings to maximize recovery.