Article Text

SURVIVING MENINGOCOCCAL SEPTIC SHOCK IN CHILDHOOD: LONG-TERM OVERALL OUTCOME
  1. C M P Buysse1,
  2. L Vermunt2,
  3. H Raat3,
  4. J Hazelzet1,
  5. W Hop4,
  6. E Utens2,
  7. K Joosten1
  1. 1Department of Paediatrics, Erasmus Mc-Sophia, Rotterdam, The Netherlands
  2. 2Department of Child and Adolescent Psychiatry, Erasmus Mc-Sophia, Rotterdam, The Netherlands
  3. 3Department of Public Health, Erasmus Mc-Sophia, Rotterdam, The Netherlands
  4. 4Department of Epidemiology and Biostatistics, Erasmus Mc-Sophia, Rotterdam, The Netherlands

Abstract

Objective To evaluate associations between long-term outcome variables, both physical and psychological, in patients who survived meningococcal septic shock (MSS) in childhood.

Patients and Methods All consecutive patients with septic shock and purpura requiring intensive care treatment between 1988 and 2001. Physical health status was assessed with a standard medical interview and physical examination; standard assessment procedures were used to measure behavioural and emotional problems, and cognitive functioning.

Results 120 patients (response rate 71%) visited the follow-up clinic (age PICU admission 3.1 years; follow-up interval 9.8 years; age follow-up 14.5 years (all medians)).

Four major outcomes were considered: Severe skin scars and/or orthopaedic sequelae (29/120), mild neurological impairments (39/120), problem behaviour defined as a total score above the 90th percentile of the reference groups (16/114) and total IQ <85 (18/115).

No differences were found between patients with major physical sequelae and patients without major physical sequelae as to the presence of problem behaviour or total IQ<85. Also, no differences were found between patients with mild neurological impairments and patients without as to the presence of problem behaviour or total IQ<85.

Some specific cases should be mentioned: 2 of the 3 patients with mental retardation had severe skin scarring and amputations; the patient with chronic renal failure had severe skin scarring, amputation of 1 leg and focal neurological signs.

Conclusions Long-term adverse physical and psychological outcomes in survivors of MSS did not seem to be associated.

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