• Kathleen L Meert, Ron Reeder, Aline B Maddux, Russell Banks, Robert A Berg, Athena Zuppa, Christopher J Newth, David Wessel, Murray M Pollack, Mark W Hall, Michael Quasney, Anil Sapru, Joseph A Carcillo, Patrick S McQuillen, Peter M Mourani, Ranjit S Chima, Richard Holubkov, Samuel Sorenson, James W Varni, Julie McGalliard, Wren Haaland, Kathryn B Whitlock, J Michael Dean, Jerry J Zimmerman, and and the Life After Pediatric Sepsis Evaluation (LAPSE) Investigators.
• Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, MI.
• Pediatr Crit Care Me. 2020 Oct 1; 21 (10): 869-878.

ObjectivesTo evaluate the physical and psychosocial domains of health-related quality of life among children during the first year following community-acquired septic shock, and explore factors associated with poor physical and psychosocial health-related quality of life outcomes.DesignSecondary analysis of the Life After Pediatric Sepsis Evaluation.SettingTwelve academic PICUs in the United States.PatientsChildren greater than or equal to 1 month and less than 18 years old who were perceived to be without severe developmental disability by their family caregiver at baseline and who survived hospitalization for community-acquired septic shock.InterventionsFamily caregivers completed the Pediatric Quality of Life Inventory for children 2-18 years old or the Pediatric Quality of Life Inventory Infant Scales for children less than 2 years old at baseline (reflecting preadmission status), day 7, and months 1, 3, 6, and 12 following PICU admission. Higher Pediatric Quality of Life Inventory Physical and Psychosocial Health Summary Scores indicate better health-related quality of life.Measurements And Main ResultsOf 204 children, 58 (28.2%) had a complex chronic comorbid condition. Children with complex chronic comorbid conditions had lower baseline physical health-related quality of life (62.7 ± 22.6 vs 84.1 ± 19.7; p < 0.001) and psychosocial health-related quality of life (68.4 ± 14.1 vs 81.2 ± 15.3; p < 0.001) than reference norms, whereas children without such conditions had baseline scores similar to reference norms. Children with complex chronic comorbid conditions recovered to their baseline health-related quality of life, whereas children without such conditions did not (physical health-related quality of life 75.3 ± 23.7 vs 83.2 ± 20.1; p = 0.008 and psychosocial health-related quality of life 74.5 ± 18.7 vs 80.5 ± 17.9; p = 0.006). Age less than 2 years was independently associated with higher month 12 physical health-related quality of life, and abnormal neurologic examination and neurologic injury suspected by a healthcare provider during the PICU course were independently associated with lower month 12 physical health-related quality of life. Treatment of increased intracranial pressure and medical device use at month 1 were independently associated with lower month 12 psychosocial health-related quality of life.ConclusionsPhysical and psychosocial health-related quality of life were reduced among children during the first year following community-acquired septic shock compared with reference norms, although many recovered to baseline. Risk factors for poor health-related quality of life included neurologic complications during the hospitalization and dependence on a medical device 1 month postadmission.

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