Educational Outcomes Of Childhood Survivors Of Critical Illness – A Population-based Linkage Study

BACKGROUND AND AIM: Major post-intensive care sequelae affect up to one in three adult survivors of critical illness. Large cohorts on educational outcomes after pediatric intensive care are lacking. We assessed primary school educational outcomes in a state-wide cohort of children who survived PICU during childhood.

METHOD: Multicentre population-based study on children <5 years admitted to PICU. Using the National Assessment Program – Literacy and Numeracy (NAPLAN) database, the primary outcome was educational achievement below the National Minimum Standard (NMS) in year 3 of primary school. Cases were compared to matched controls. Multivariable logistic regression models to predict educational outcomes were derived.

RESULTS: Year 3 primary school data were available for 5,017 PICU survivors. PICU survivors scored significantly lower than controls across each domain (p<0.001). 14.03% of PICU survivors did not meet the NMS, compared to 8.96% of matched controls (p<0.001). In multivariate analyses socioeconomic status (OR 2.14; 95%-CI 1.67-2.74), weight (0.94; 0.90 - 0.97), logit of Pediatric Index of Mortality-2 score (1.11; 1.03-1.19), presence of a syndrome (11.58; 8.87-15.11), prematurity (1.54; 1.09-2.19), chronic neurological conditions (4.38; 3.27-5.87), chronic respiratory conditions (1.65; 1.24-2.19), and RRT (4.20; 1.40-12.55) were associated with a higher risk of not meeting the NMS.

CONCLUSIONS: In this population-based study of childhood PICU survivors, one in six did not meet national minimum standards in the standardized primary school assessment. Socioeconomic status, underlying diseases, and severity on presentation allow risk-stratification to identify children most likely to benefit from individual follow-up and support.