Introduction: Pediatric survivors of acute respiratory distress syndrome (PARDS) face persistent physical and psychosocial sequelae, yet post-discharge mental-health outcomes remain undefined. Recent U.S. commercial-claims data showed 8% of children admitted to an ICU developed a new mental health diagnosis within 12 months. We aimed to quantify the incidence of new mental health diagnoses and psychotropic medication dispensing in the year following PARDS hospitalization. Methods: We analyzed the 2016-2023 IBM Marketscan Commercial and Medicaid claims database. Children aged 6–18 years with an index admission meeting a validated ICD10 PARDS algorithm and surviving to discharge were included. Patients with < 3 months continuous insurance coverage post-discharge were excluded. Outcomes were (1) first inpatient or outpatient claim containing ICD10 codes for anxiety or PTSD (F41.x, F43), depression (F3234, F39), suicidality/self-harm (R45.8, T14.91, X7183), or other/unspecified disorders (F99), and (2) first dispensing of an antidepressant, antipsychotic, or other psychotropic within 90 and 365 days. For mental health diagnoses, patients could develop more than one disease category illness. AI was used in abstract refinement and stats program coding. Results: Among 7,097 survivors (median age 14 y; IQR 9-17; median LOS 10 d), 36.6% (n=2,598) carried a mental health diagnosis of interest at discharge (anxiety 5.3%, depression 4.9%). In the year following PARDS, 13% (n = 895) had a new anxiety diagnosis, 8.4% (n=588) new depression, 4.9% (n=343) new suicidality/self-harm, and 36% (n=2,515) had a new other/unspecified mental health disorder. Suicidality or suicide attempt resulted in hospitalization in 3.3% (n=231) patients. Psychotropic medication was initiated within 90 days in 20.2% (n= 1,422) of survivors with antidepressants (15.0%, n=717) the most common medication initiated. At one-year after discharge, 27.3% (n=1,934) had received any psychotropic prescription and 15.9% (n=1,128) an antidepressant. Conclusions: New mental health diagnoses in survivors of PARDS are common. Access to mental health care both at discharge and in the year following PARDS should be a cornerstone of post ICU care. Future work is needed to identify modifiable PARDS course factors that may contribute to mental health diagnoses.
Senthil et al. (Sun,) studied this question.
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