PDF herunterladen
J Pediatr Intensive Care
DOI: 10.1055/s-0044-1787671
Original Article

Kindergarten Readiness Assessment Scores in Children who Received Early Life Mechanical Ventilation in the Pediatric Intensive Care Unit

Steven L. Shein 
1   Division of Pediatric Critical Care Medicine, Rainbow Babies and Children's Hospital, Cleveland, Ohio, United States
2   School of Medicine, Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, United States
,
Alena D'Alessio
3   Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, United States
,
Lena Baker 
1   Division of Pediatric Critical Care Medicine, Rainbow Babies and Children's Hospital, Cleveland, Ohio, United States
,
Meredith Fischer
2   School of Medicine, Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, United States
,
Robert Fischer
3   Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, United States
,
Deanne Wilson-Costello 
4   Division of Neonatology, Rainbow Babies and Children's Hospital, Cleveland, Ohio, United States
,
Aline B Maddux 
5   Section of Pediatric Critical Care Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado, United States
,
Francisca Garcia-Cobian Richter
3   Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, United States
› Institutsangaben
Funding This study was funded by the University Hospital Research and Education Institute.
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

The impact of prolonged sedative medication usage on cognitive outcomes of young pediatric intensive care unit (PICU) patients has been incompletely assessed. We aim to assess the feasibility of linking an electronic medical record (EMR) system and a regional database to evaluate performance on standardized testing among PICU survivors. This is a single-center data-linkage study between EMR records and the Child and Household Integrated Longitudinal Data (CHILD) system, which links individual-level data across 35 administrative systems including Kindergarten Readiness Assessment (KRA) scores. The study was performed at a tertiary PICU in Cleveland, Ohio, United States with children born in 2011 or 2012 who received invasive mechanical ventilation and sedation before the age of 3 years in our PICU. We evaluated rate of “on-track” KRA scores, chronic absenteeism, and repeat kindergarten in the study population compared with a propensity score matched cohort from CHILD. Of 182 eligible PICU patients, 98 (54%) had a record identified in CHILD, and 32 had KRA scores available and sufficient data for propensity score matching. Compared with 160 matched controls, PICU patients had a lower rate of “on-track” scores (7/32 [22%] vs 102/160 [64%], p < 0.001) and more chronic absenteeism (14/32 [44%] vs. 34/160 [22%], p = 0.007). There was no difference in rates of repeat kindergarten (8/32 [25%] vs. 36/160 [23%], p  =  ;−0.759). We determined that linking hospital EMR records to regional databases is a feasible method to explore PICU outcomes. Additional studies are needed to confirm our preliminary finding of poor performance compared with matched controls.

Keywords

data-linkage - sedation - PICU outcomes


Publikationsverlauf

Eingereicht: 11. Oktober 2023

Angenommen: 23. April 2024

Artikel online veröffentlicht:
10. Juli 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Glatz P, Sandin RH, Pedersen NL, Bonamy AK, Eriksson LI, Granath F. Association of anesthesia and surgery during childhood with long-term academic performance. JAMA Pediatr 2017; 171 (06) e163470
    CrossrefPubMedSuche in Google Scholar
  • 2 O'Leary JD, Janus M, Duku E. et al. A population-based study evaluating the association between surgery in early life and child development at primary school entry. Anesthesiology 2016; 125 (02) 272-279
    CrossrefPubMedSuche in Google Scholar
  • 3 Graham MR, Brownell M, Chateau DG, Dragan RD, Burchill C, Fransoo RR. Neurodevelopmental assessment in kindergarten in children exposed to general anesthesia before the age of 4 years: a retrospective matched cohort study. Anesthesiology 2016; 125 (04) 667-677
    CrossrefPubMedSuche in Google Scholar
  • 4 Center for Drug Evaluation and Research. FDA Drug Safety Communication: New Results Warning About Using General Anesthetics and Sedation Drugs in Young Children and Pregnant Women. Accessed July 1, 2022 at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-review-results-new-warnings-about-using-general-anesthetics-and
    PubMed
  • 5 Ong C, Lee JH, Leow MK, Puthucheary ZA. Functional outcomes and physical impairments in pediatric critical care survivors: a scoping review. Pediatri Crit Care Med 2016; 17 (05) e247-e259
    CrossrefPubMedSuche in Google Scholar
  • 6 Massagli TL, Dudgeon BJ, Ross BW. Educational performance and vocational participation after spinal cord injury in childhood. Arch Phys Med Rehabil 1996; 77 (10) 995-999
    CrossrefPubMedSuche in Google Scholar
  • 7 de Louvois J, Halket S, Harvey D. Effect of meningitis in infancy on school-leaving examination results. Arch Dis Child 2007; 92 (11) 959-962
    CrossrefPubMedSuche in Google Scholar
  • 8 Kyösti E, Peltoniemi O, Liisanantti JH. et al. School performance after pediatric intensive care-association of mental well-being, chronic illnesses, and family socioeconomic status. Pediatr Crit Care Med 2020; 21 (12) e1099-e1105
    CrossrefPubMedSuche in Google Scholar
  • 9 Carlton EF, Donnelly JP, Prescott HC. et al; RESTORE Study Investigators. School and work absences after critical care hospitalization for pediatric acute respiratory failure: a secondary analysis of a cluster randomized trial. JAMA Netw Open 2021; 4 (12) e2140732
    CrossrefPubMedSuche in Google Scholar
  • 10 Als LC, Nadel S, Cooper M, Pierce CM, Sahakian BJ, Garralda ME. Neuropsychologic function three to six months following admission to the PICU with meningoencephalitis, sepsis, and other disorders: a prospective study of school-aged children. Crit Care Med 2013; 41 (04) 1094-1103
    CrossrefPubMedSuche in Google Scholar
  • 11 Tomaszewski W, Ablaza C, Straney L, Taylor C, Millar J, Schlapbach LJ. Australian & New Zealand Intensive Care Society (ANZICS) Centre for Outcomes & Resource Evaluation (CORE) and the Australian & New Zealand Intensive Care Society Paediatric Study Group (ANZICS PSG). Educational outcomes of childhood survivors of critical illness-a population-based linkage study. Crit Care Med 2022; 50 (06) 901-912
    CrossrefPubMedSuche in Google Scholar
  • 12 Fischer RL, Garcia-Cobian Richter F, Anthony E. et al. Leveraging administrative data to better serve children and families. Public Adm Rev 2019; 79: 675-683
    CrossrefPubMedSuche in Google Scholar
  • 13 Coulton C, Fischer R, Lalich N. et al. An IDS Resource for Cuyahoga County: ChildHood Integrated Longitudinal Data System. The Center on Poverty and Community Development. Accessed July 1, 2019 at: https://case.edu/socialwork/povertycenter/
    PubMed
  • 14 Ho D, Imai K, King G. et al. MatchIt: nonparametric preprocessing for parametric causal inference. J Stat Softw 2011; 42 (08) 1-28
    Suche in Google Scholar
  • 15 Neighborhood Atlas®. Neighborhood Atlas – Mapping. Accessed July 1, 2019 at: https://www.neighborhoodatlas.medicine.wisc.edu/mapping
    PubMed
  • 16 Ohio's Kindergarten Readiness Assessment. Ohio Department of Education. Accessed July 1, 2019 at: https://education.ohio.gov/Topics/Early-Learning/Kindergarten/Ohios-Kindergarten-Readiness-Assessment
    PubMed
  • 17 Cenzer I, Boscardin WJ, Berger K. Performance of matching methods in studies of rare diseases: a simulation study. Intractable Rare Dis Res 2020; 9 (02) 79-88
    CrossrefPubMedSuche in Google Scholar
  • 18 Shonkoff JP, Slopen N, Williams DR. Early childhood adversity, toxic stress, and the impacts of racism on the foundations of health. Annu Rev Public Health 2021; 42: 115-134
    CrossrefPubMedSuche in Google Scholar
  • 19 Jenkins A, Culhane D. Integrated data systems in the US: a national survey of state and local governments and their university partners. Int J Popul Data Sci 2019; 4 (03) x
    PubMedSuche in Google Scholar