Functional evaluation of pediatric patients after discharge from the intensive care unit using the Functional Status Scale

ABSTRACT Objective: To evaluate the functional status of pediatric patients after discharge from the pediatric intensive care unit using the Functional Status Scale and to compare the time of invasive mechanical ventilation, length of stay in the pediatric intensive care unit, and Pediatric Index of Mortality 2 results among individuals with different degrees of functional impairment. Methods: A cross-sectional study was conducted on patients who were discharged from a pediatric intensive care unit. The functional evaluation by the Functional Status Scale was performed on the first day after discharge from the unit, and the Pediatric Index of Mortality 2 was used to predict the mortality rate at the time of admission to the pediatric intensive care unit. Results: The sample consisted of 50 individuals, 60% of which were male, with a median age of 19 [6 - 61] months. The overall score of the Functional Status Scale was 11.5 [7 - 15], and the highest scores were observed in the "motor function" 3 [1 - 4] and "feeding" 4 [1 - 4] domains. Compared to patients who were not readmitted to the pediatric intensive care unit, patients who were readmitted presented a worse overall score (p = 0.01), worse scores in the "motor function" (p = 0.01), "feeding" (p = 0.02), and "respiratory" (p = 0.036) domains, and a higher mortality rate according to the Pediatric Index of Mortality 2 (p = 0.025). Conclusion: Evaluation of the functional status using the Functional Status Scale indicated moderate impairment in patients after discharge from the pediatric intensive care unit, mainly in the "motor function" and "feeding" domains; patients who were readmitted to the pediatric intensive care unit demonstrated worse overall functional, motor function, feeding and respiratory scores. Individuals with greater functional impairment had longer times of invasive mechanical ventilation and hospitalization in the pediatric intensive care unit.

摘要
研究目的：本研究旨在通过功能状态量表（Functional Status Scale）评估儿科重症监护病房（pediatric intensive care unit）出院患儿的功能状态，并比较不同功能损害程度受试者的有创机械通气时长、儿科重症监护病房住院时长及儿童死亡风险指数2（Pediatric Index of Mortality 2）结果。
研究方法：本研究为横断面研究，纳入某儿科重症监护病房的出院患儿。于患儿出院后首日采用功能状态量表开展功能评估，并在患儿入住儿科重症监护病房时采用儿童死亡风险指数2预测其入院时的死亡率。
研究结果：本研究共纳入50例受试者，其中男性占比60%，中位年龄为19[6 - 61]月龄。功能状态量表总分为11.5[7 - 15]，各维度中“运动功能”维度得分最高，为3[1 - 4]，“进食”维度得分次之，为4[1 - 4]。与未再次入住儿科重症监护病房的患儿相比，再次入住的患儿总功能评分更低（p = 0.01），“运动功能”（p = 0.01）、“进食”（p = 0.02）及“呼吸”（p = 0.036）维度得分均更差，且依据儿童死亡风险指数2计算的死亡率更高（p = 0.025）。
研究结论：采用功能状态量表评估儿科重症监护病房出院患儿的功能状态，结果显示其存在中度功能损害，尤以“运动功能”与“进食”维度为著；再次入住儿科重症监护病房的患儿总体功能、运动功能、进食功能及呼吸功能评分均更差。功能损害程度更严重的受试者，其有创机械通气时长及儿科重症监护病房住院时长更长。