Background and Aims

Approximately 2 out of 1000 children require critical care support, but little is known about the impact of critical illness into school performance. While major post-intensive care sequelae affect up to one in three adult survivors of critical illness, similar data for critically ill children are lacking.

We aimed to determine primary school educational outcomes in children who required admission to PICU during childhood.

Methods

Multicentre population-based linkage study. Children <5 years old admitted to PICU in Queensland, Australia, between 1997 and 2016 were eligible if they had survived until the age of NAPLAN testing. Using the National Assessment Program – Literacy and Numeracy (NAPLAN) database, the primary outcome was defined as educational achievement below the National Minimum Standard (NMS) in year 3 of primary school.

Results

Primary school data were available for 5,017 PICU survivors (median age 8.0 months at first PICU admission). 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), logit of Pediatric Index of Mortality-2 score (1.11; 1.03-1.19), and presence of a syndrome (11.58; 8.87-15.11) were some of the key predictors of not meeting the NMS.

Conclusions

In this study of childhood PICU survivors, 14.03% 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.