Efficiency of PICU using Functional Status Scale (FSS): A Pilot Study

Background: Several clinical predictors model have been reported for the outcome of acute critically ill children from Pediatric Intensive care units (PICUs) globally. Limited data is available on functional state of children at discharge from PICU. Objective: To assess the efficiency of a PICU by evaluating functional recovery in children from admission to discharge using the Functional Status Scale (FSS). Study design: This is a descriptive, observational study. Setting: This study was conducted in the PICU of Children’s Hospital Korangi, Karachi, Pakistan. Duration of study: Four-month period (From December 5th, 2023, to March 30th, 2024). Methods: A total of 225 patients were enrolled. Patients admitted for more than 24 hours and discharged alive were retrospectively reviewed. FSS scores were recorded within the first 24 hours of admission and again at discharge from PICU. Patients were categorized into two groups: Group A (FSS ≤9) and Group B (FSS >10). Demographic and clinical variables, including age, gender, primary diagnosis, mechanical ventilation, vasoactive support, length of stay, and Pediatric Risk of Mortality (PRISM III) scores, were analyzed. Results: The median (IQR) age of participants was 10 months (4-24 months); 69.3% of under 2 years of age, with a male predominance of 60%. Respiratory diseases were the leading cause of admission, 86.6%, followed by neurological conditions. The median PRISM-III scores and median FSS score were 28 (21-29.8) and 22 (18-27) at admission, respectively. The median of total score declined markedly from 23 (IQR 18–27) at admission to 8 (IQR 7–9) at discharge. 84.4%(n=190) of patients achieved FSS near-normal, and 46% (n=104) were 6 (normal health) at discharge. Only 15.6% (n=35) had moderate to severe impairments in functional state at discharge. Conclusion: Nearly 85% of acute critically-ill children regained the normal functional and health state at discharge from PICU in this study. Further larger studies are needed to validate our results.