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High Burden of Acquired Morbidity in Survivors of Pediatric Acute Respiratory Distress Syndrome
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  • Sin Wee Loh,
  • Ming Ying Gan,
  • Judith Ju-Ming Wong,
  • Chengsi Ong,
  • Yee Hui Mok,
  • Jan Hau Lee
Sin Wee Loh
KK Women's and Children's Hospital
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Ming Ying Gan
National University Singapore Yong Loo Lin School of Medicine
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Judith Ju-Ming Wong
KK Women's and Children's Hospital
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Chengsi Ong
KK Women's and Children's Hospital
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Yee Hui Mok
KK Women's and Children's Hospital
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Jan Hau Lee
KK Women's and Children's Hospital
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Abstract

Introduction: With improving mortality rates in pediatric acute respiratory distress syndrome (PARDS), functional outcomes in survivors are increasingly important. We aim to describe the change in functional status score (FSS) from baseline to discharge and to identify risk factors associated with poor functional outcomes. Methods: We examined clinical records of patients with PARDS admitted to our pediatric intensive care unit (PICU) from 2009 to 2016. Our primary outcome was acquired morbidity at PICU and hospital discharge (defined by an increase in FSS ≥3 points above baseline). We included severity of illness scores and severity of PARDS in our bivariate analysis for risk factors for acquired morbidity. Results: There were 181 patients with PARDS, of which 90 (49.7%) survived. Median pediatric index of mortality 2 score was 4.05 (1.22, 8.70) and 21 (26.6%) patients had severe PARDS. 59 (65.6%) and 14 (15.6%) patients had acquired morbidity at PICU and hospital discharge, respectively. Median baseline FSS was 6.00 (6.00, 6.25), which increased to 11.00 (8.75, 12.00) at PICU discharge before decreasing to 7.50 (6.00, 9.25) at hospital discharge. All patients had significantly higher median FSS score at both PICU and hospital discharge compared to baseline. Feeding and respiratory were the most affected domains. After adjusting for severity of illness, severity categories of PARDS was not a risk factor for acquired morbidity. Conclusion: Acquired morbidity in respiratory and feeding domains was common in PARDS survivors. Specific attention should be given to these two domains of functional outcomes in these children.

Peer review status:ACCEPTED

10 Mar 2021Submitted to Pediatric Pulmonology
10 Mar 2021Submission Checks Completed
10 Mar 2021Assigned to Editor
11 Mar 2021Reviewer(s) Assigned
04 Apr 2021Review(s) Completed, Editorial Evaluation Pending
07 Apr 2021Editorial Decision: Revise Major
30 Apr 20211st Revision Received
03 May 2021Submission Checks Completed
03 May 2021Assigned to Editor
03 May 2021Reviewer(s) Assigned
19 May 2021Review(s) Completed, Editorial Evaluation Pending
21 May 2021Editorial Decision: Accept