A – 44 Factors Affecting Cognitive Recovery in a Pediatric Acquired Brain Injury Post-Pediatric Intensive Care Unit (PICU) Sample

Abstract Objective Pediatric intensive care unit (PICU) survivors with acquired brain injury (ABI) have increased risk for neurocognitive morbidities. We evaluated associations between key factors and long-term neurocognitive recovery groups. Method After clinical referral from early triage screening (4-6 weeks post-hospital discharge), 110 youth aged 6-19 years completed neuropsychological evaluation (9-12 months post-hospital discharge). We used the Cognitive Status Scale (CSS), a psychometrically robust tool for summarizing flexible assessment batteries into a single performance-based metric (CSS Total Score) and categorization into recovery groups: (1) fully recovered; (2) possible but limited evidence of change; (3) notable evidence of change; (4) no evidence of change, low scores reflective of premorbid status. We utilized ANOVA to compare CSS Total Score and X2 to compare key factors across recovery groups. Results A statistically significant difference emerged in mean CSS Total Scores across recovery groups (F(3, 106) = [8.4495], p = <.001, η2 =.194, Large), with lowest scores in groups 3 and 4. Significant differences were found across categories with multiple factors germane to cognitive outcomes including Medicaid insurance (28.6%, 33.3%, 63.2%, 42.9%; X2=7.944(3); p<.05), pre-morbid neurodevelopmental comorbidities (28.6%, 66.7%, 17.1%, 50%; X2=12.7(3); p=.005), and receipt of critical care interventions (78.6%, 83.3%, 80%, 36%; X2=12.6(3); p=.006). Conclusion Recovery groups reveal important differences in premorbid status and injury severity that should be accounted for in ABI cognitive outcomes research. Future work should specifically evaluate key differences between categories 1 (fully recovered) and 3 (impacted by ABI hospitalization) to assess modifiable factors impacting outcomes specific to PICU hospitalization.