Pediatr Investig. 2024 Mar 18;8(2):108-116. doi: 10.1002/ped4.12422. eCollection 2024 Jun.

ABSTRACT

IMPORTANCE: Critically ill children with pre-existing mental health conditions may have an increased risk of poor health outcomes.

OBJECTIVE: We aimed to evaluate if pre-existing mental health conditions in critically ill pediatric patients would be associated with worse clinical outcomes, compared to children with no documented mental health conditions.

METHODS: This retrospective observational cohort study utilized the TriNetX electronic health record database of critically ill subjects aged 12-18 years. Data were analyzed for demographics, pre-existing conditions, diagnostic, medication, procedural codes, and mortality.

RESULTS: From a dataset of 102 027 critically ill children, we analyzed 1999 subjects (284 [14.2%] with a pre-existing mental health condition and 1715 [85.8%] with no pre-existing mental health condition). Multivariable analysis demonstrated that death within one year was associated with the presence of pre-existing mental health conditions (odds ratio 8.97 [3.48-23.15], P < 0.001), even after controlling for the presence of a complex chronic condition.

INTERPRETATION: The present study demonstrates that the presence of pre-existing mental health conditions was associated with higher odds of death within 1 year after receiving critical care. However, the confidence interval was wide and hence, the findings are inconclusive. Future studies with a larger sample size may be necessary to evaluate the true long-term impact of children with pre-existing mental health conditions who require critical care services.

PMID:38910847 | PMC:PMC11193371 | DOI:10.1002/ped4.12422