Functional evaluation of children on discharge from pediatric intensive care unit using functional status scale

Introduction: Despite a reduction in pediatric critical care mortality rates over the past three decades, morbidity among survivors has increased noticeably. The Functional Status Scale (FSS) serves as a crucial tool for evaluating morbidity in these patients. This study aims to assess FSS scores in children upon discharge from the pediatric intensive care unit (PICU) and three months later. Methodology: A prospective observational study was conducted at Shifa International Hospital from January to June 2023. FSS scores were collected pre-illness, upon admission, discharge, and at a three-month follow-up. Demographics and clinical data were obtained via a predetermined questionnaire. Results: Of 191 patients, 132 were included, with a median age of 54 months (range: 12-114) and 76 (57%) males. The median PRISM score was 3 (range: 0-7). Acute respiratory illnesses 24(18%) and neuromuscular illnesses 22 (16%) were the most common diagnostic categories. New morbidity incidence between pre-illness and discharge was 24(18%), and between pre-illness and follow-up was 5(3.7%). Children with neuromuscular diseases had significantly higher new morbidity risks at both discharge and follow-up. Length of PICU stay and duration of mechanical ventilation showed significant associations. Conclusion: The study revealed 18% new morbidity incidence at PICU discharge and 3.7% at 03-month follow-up. Neuromuscular disease patients were notably vulnerable. These findings emphasize the need for ongoing functional assessments and targeted interventions, especially for pediatric ICU survivors with neuromuscular conditions.