Factors Associated With Health-Related Quality of Life Changes in Survivors to Pediatric Intensive Care

OBJECTIVE: To determine predictors of change in the health-related quality of life in survivors to pediatric intensive care, based on preadmission health status, demographic characteristics, and physiological variables. DESIGN: Prospective evaluation of health-related quality of life at PICU admission and after 6 months. SETTING: Three PICUs at tertiary hospitals. PATIENTS: Children aged ≥ 6 yrs admitted to the PICUs between May 2002 and June 2004. INTERVENTIONS: Health Utilities Index Mark 3 questionnaire was administered to a child proxy by direct interview at admission and by telephone interview at follow-up. MEASUREMENTS AND MAIN RESULTS: From the 517 eligible admissions, 44 (8.5%) children died in the PICU and 252 had a follow-up assessment. From a list of 115 analyzed variables, 29 (25%) and 30 (26%) were selected (p < .10) for a multivariable model predicting improvement and deterioration of the health-related quality of life, respectively. In the final models, only mechanical ventilation, preadmission global score of Health Utilities Index Mark 3, and preadmission Health Utilities Index Mark 3 pain attribute were associated with improvement; and main diagnostic group, preadmission Health Utilities Index Mark 3 emotion attribute, and preadmission Health Utilities Index Mark 3 pain attribute were associated with deterioration in the health-related quality of life. CONCLUSIONS: The most common variables used to compute probability of death algorithms were not capable of predicting health-related quality of life in survivors to pediatric intensive care. The preadmission health-related quality of life and trauma admissions are important variables to predict change in the health-related quality of life of children surviving to pediatric intensive care.