Article Text

LONG-TERM HEALTH STATUS IN SURVIVORS OF MENINGOCOCCAL SEPTIC SHOCK IN CHILDHOOD
  1. C M P Buysse1,
  2. H Raat1,
  3. J A Hazelzet1,
  4. J Hulst1,
  5. K Cransberg1,
  6. W Hop1,
  7. M Maliepaard1,
  8. K Joosten1
  1. 1Department of Paediatrics, Erasmus Mc-Sophia, Rotterdam, The Netherlands

Abstract

Objective To assess long-term health status in patients who survived meningococcal septic shock (MSS) in childhood.

Design A medical and psychological follow-up of a cross-sectional cohort.

Patients and Methods All consecutive patients with septic shock and purpura requiring intensive care treatment at the paediatric intensive care unit (PICU) of the Erasmus Mc-Sophia Children’s Hospital, The Netherlands, between 1988 and 2001. Parents and patients were invited to the follow-up clinic 4–16 years after PICU discharge. Health status was assessed with a standard medical interview, physical examination, renal function and health utilities index (HUI) marks 2 and 3.

Results 120 patients (response rate 71%) visited the follow-up clinic (age of PICU admission 3.1 years; follow-up interval 9.8 years; age at follow-up 14.5 years (all medians)). 35% had one or more of the following neurological impairment(s): severe mental retardation with epilepsy (3%), hearing loss (2%), chronic headache (28%) or focal neurological signs such as paresis of one arm (6%). One of the 16 patients with septic shock-associated acute renal failure at PICU admission showed signs of mild chronic renal failure (glomerular filtration rate 62 ml/min per 1.73 m2, proteinuria and hypertension). Significantly lower scores were found on nearly all HUI2 and HUI3 attributes compared with normative Dutch data, indicating poorer health status.

Conclusions In patients who survived MSS in childhood, one third showed long-term neurological impairments, ranging from mild to severe and irreversible. Patients reported poorer general health status as measured by HUI2 and HUI3.

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