Performance of a Provider-Assigned Functional Outcome Score in Critically Ill Children

Abstract

Objectives: Determine agreement between Pediatric Cerebral Performance Category (PCPC) scores integrated into clinical workflow and traditional investigator-assigned scores. Design: Longitudinal study. Setting: A single-center quaternary-care academic institution. Subjects: Children admitted to the PICU between November 2019 and April 2020. Interventions: Providers assigned PCPC scores as part of daily workflow. Investigators assigned scores using retrospective chart review. Measurements and Main Results: Of 803 patients admitted to the PICU, 782 survived and were included. Admission and discharge scores were recorded in 95% and 90% of patients, respectively. Agreement between provider- and investigator-assigned scores was excellent, with a weighted kappa of 0.87 (95% CI, 0.84–0.90) and 0.80 (95% CI, 0.76–0.84) for admission and discharge. Conclusions: Provider-assigned PCPC scores, documented as standard of care, are largely concordant with retrospective investigator-assigned scores. Measurement of cognitive functional status can be successfully integrated into daily provider workflow for use in the clinical, quality improvement, and research arenas.