A – 46 The Cognitive Status Scale (CSS): A report on initial psychometric properties for a new research measure targeting post-pediatric intensive care unit (PICU) cognitive outcomes

Objective Cognitive morbidities persist after pediatric critical care. Gaps exists related to measuring cognitive outcomes due to heterogeneity in patient presentations and objective measures commonly utilized in long-term clinical care. We developed a coding system designed to summarize clinically generated and performance-based neurocognitive outcomes to be used for research. Method After clinical referral from early triage screening (4-6 weeks post-hospital discharge), 110 critically injured/ill youth aged 6-19 years completed an individually tailored clinical neuropsychological evaluation (9-12 months post-hospital discharge). The CSS was retrospectively coded and scored. Results Principal components analysis supported the CSS structure (59% of the total explained variance). Internal consistency (α = .82) and interrater reliability (r = .92) were good. Criterion-related validity: CSS Total Composite Score from long-term evaluation was significantly correlated with abbreviated performance-based cognitive outcomes from the acute recovery phase (r=.74). Divergent validity: significant differences on the CSS Total Composite Score between known clinical groups (≥3 Functional Status Scale [FSS] change = 30.23 vs. ≤2 FSS change=50.94, t=4.10, p≤.001, d =.91). Bivariate correlations showed significant associations in the expected direction between the CSS Total Composite Score and the FSS Total Score (r=-.44, p≤.001), as well as between the CSS Total Composite Score the BRIEF-2 GEC (r=-.29, p=.010). Conclusion Preliminary evidence shows the CSS to be a reliable and valid measure for summarizing a clinically administered battery of individually administered cognitive assessments. Easy to generate metrics of performance-based cognition are essential to progress the state of the science related to cognitive outcomes post pediatric critical care.