Risk Factors for Mortality and Functional Status Among Survivors of Pediatric Acute Respiratory Distress Syndrome

Abstract

Abstract Purpose Although the mortality rate of pediatric acute respiratory distress syndrome (PARDS) continues to decrease, the increased incidence of clinical sequelae in survivors has become a focus of clinical practice. This study aimed to determine the functional status at hospital discharge among PARDS survivors using the Functional Status Scale and identify risk factors associated with its mortality. Methods We retrospectively collected and analyzed clinical data of patients with PARDS assessed upon admission and discharge from the pediatric intensive care unit of our hospital between January 2013 and January 2020. Patients were categorized into survival and non-survival groups for intergroup comparisons of clinical characteristics and therapeutic interventions. Results Of the 149 study participants, 96 (64.4%) died while hospitalized and 53 (35.6%) survived until discharge. Severe PARDS, defined as an oxygenation index score of ≥ 16, was an independent risk factor for mortality. Although surviving participants showed improvements in clinical status, the rate of new morbidity at discharge was 24.5%, with respiratory, feeding, and motor functions being the domains most affected. Conclusion Severe PARDS was an independent risk factor for mortality. Despite the survival of one out of three patients with PARDS, approximately a quarter of survivors experienced new morbidities after discharge. The most commonly affected functions included those related to respiration, feeding, and motor activity; therefore, special attention should be given to maintaining these functions in survivors.