Risk Factors for Mortality and Functional Status Among Survivors of
Pediatric Acute Respiratory Distress Syndrome
Abstract
Objectives: Although the mortality rate of pediatric acute
respiratory distress syndrome (PARDS) continues to decrease, the
increased incidence of clinical sequelae in survivors has become a focus
of clinical practice. This study aimed to determine the functional
status of PARDS survivors at hospital discharge using the Functional
Status Scale and to identify risk factors associated with mortality.
Methods: We retrospectively analyzed the clinical data of
patients with PARDS assessed upon admission and discharge from our
hospital’s pediatric intensive care unit between January 2013 and
January 2020. Patients were categorized into survival and non-survival
groups for intergroup clinical characteristics and therapeutic
intervention comparisons. Results: Of the 149 study
participants, 96 (64.4%) died during hospitalization, and 53 (35.6%)
survived until discharge. Severe PARDS, defined as an oxygenation index
score of ≥16, was an independent risk factor for mortality. Although
surviving participants showed improvements in their clinical status, the
new morbidity rate at discharge was 24.5%, with respiratory, feeding,
and motor functions being the domains most affected.
Conclusion: Severe PARDS was an independent risk factor for
mortality. Despite the PARDS survival rate for the participants being
33.33%, approximately a quarter of survivors experienced new
morbidities after discharge. The most affected functions included those
related to respiration, feeding, and motor activity; therefore, special
attention should be given to maintaining these functions in survivors.