Health-related quality of life in survivors of acute respiratory illness who required invasive mechanical ventilation in a tertiary pediatric intensive care unit – A prospective follow-up observational study
Siva Vyasam, Samuel P Oommen, Ebor Jacob James, Jewel John Ponvelil, P PragatheshAbstract
Background:
The pediatric intensive care unit (PICU) has reduced mortality, but survival alone does not reflect long-term outcomes. Health-related quality of life (HRQoL) is a key measure of recovery, with limited data in PICU survivors, especially in India. This study aimed to evaluate long-term HRQoL in previously healthy children following acute respiratory illness requiring invasive mechanical ventilation.
Subjects and Methods:
This prospective follow-up observational study was conducted in a tertiary care PICU in Southern India. Children aged 1 month–15 years requiring mechanical ventilation for >48 h between March 2008 and February 2014 and discharged alive were included; neonates and those with chronic illnesses were excluded from the study. HRQoL was assessed using the health utility index 2 (HUI2) through telephone or in-person interviews across six domains, and categorized as normal (>0.99), fair (0.89–0.99), or poor (<0.89).
Results:
Of 146 eligible survivors, 66 (mean age 7.8 ± 2.6 years) were assessed >3-year postdischarge. The mean HUI2 score was 0.94 ± 0.062. Fifty-five (83.3%) had normal or fair HRQoL, whereas 11 (16.7%) had poor HRQoL with involvement of more than one domain. Cognition (35%) was most affected, followed by emotion (19%) and sensation (17%); mobility was least affected (1.5%). Longer PICU stay, ventilation complications, and multiorgan dysfunction were associated with poorer outcomes but were not statistically significant.
Conclusions:
Most survivors of mechanical ventilation (83%) had good long-term HRQoL more than 3 years after discharge, with only a minority showing deficits in cognition, emotion, or sensation. Structured follow-up is essential to address these residual challenges.