School and Work Absences After Critical Care Hospitalization for Pediatric Acute Respiratory Failure: A Secondary Analysis of a Cluster Randomized Trial.
School and Work Absences After Critical Care Hospitalization for Pediatric Acute Respiratory Failure: A Secondary Analysis of a Cluster Randomized Trial.
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儿童急性呼吸衰竭重症监护住院后的学校和工作缺勤：整群随机试验的二次分析。
DOI：
10.1001/jamanetworkopen.2021.40732
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发表时间：
2021-12-01
影响因子：
13.8
通讯作者：
RESTORE Study Investigators
中科院分区：
文献类型：
--
作者：
Carlton EF;Donnelly JP;Prescott HC;Asaro LA;Barbaro RP;Watson RS;Curley MAQ;RESTORE Study Investigators
How often and for how long do children and their caregivers miss school or work after critical care hospitalization for acute respiratory failure? In this secondary analysis of the Randomized Evaluation of Sedation Titration for Respiratory Failure clinical trial, more than two-thirds of children missed school after discharge for a median of 9.1 days. Among primary caregivers, more than half missed work after their child’s hospitalization for a median of 2 days. These findings suggest that children and their caregivers often miss school or work after critical care hospitalization for acute respiratory failure; these children may be at increased risk of lower educational achievement, economic hardship, and poor health outcomes in adulthood. This secondary analysis of a cluster randomized trial measures the rate and duration of school and work absence among children who survived hospitalization for acute respiratory failure and their caregivers, respectively. Patients who survive pediatric critical illness and their caregivers commonly experience physical, emotional, and cognitive sequelae. However, the rate and duration of school absence among patients and work absence among their caregivers are unknown. To determine the rates and duration of school absence among children who survived hospitalization with acute respiratory failure and work absence among their caregivers. The Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) cluster randomized trial included 2449 children from 31 sites to protocolized sedation (intervention) vs usual care (control) from June 6, 2009, to December 2, 2013. In total, 1360 children survived hospitalization and were selected for follow-up at 6 months after pediatric intensive care unit (PICU) discharge, which was completed from January 12, 2010, to April 13, 2015. This secondary analysis was conducted from July 1, 2020, to September 30, 2021. PICU hospitalization for acute respiratory failure, including invasive mechanical ventilation. Postdischarge assessments with caregivers of eligible participants at 6 months after PICU discharge, including questions about school and work absence. Risk factors associated with longer absence from school and work were identified. Postdischarge assessments were completed for 960 children who survived treatment for acute respiratory failure, of whom 443 (46.1%) were girls and 517 (53.9%) were boys; 509 of 957 (53.2%) were non-Hispanic White. Median age was 1.8 years (IQR, 0.4-7.9 years). In total, 399 children (41.6%) were enrolled in school, of whom 279 (69.9%) missed school after discharge. Median duration of postdischarge absence was 9.1 days (IQR, 0-27.9 days) among all children enrolled in school and 16.9 days (IQR, 7.9-43.9 days) among the 279 children with postdischarge absence. Among 960 primary caregivers, 506 (52.7%) were employed outside the home, of whom 277 (54.7%) missed work. Median duration of postdischarge work absence was 2 days (IQR, 0-10 days) among all employed primary caregivers, and 8 days (IQR, 4-20 days) among the 277 caregivers who missed work after discharge. The odds of postdischarge school absence and greater duration of absence increased for children 5 years or older (compared with 0-4 years, odds ratios [ORs] for 5-8 years, 3.20 [95% CI, 1.69-6.05] and 2.09 [95% CI, 1.30-3.37], respectively; ORs for 9-12 years, 2.49 [95% CI, 1.17-5.27] and 2.32 [95% CI, 1.30-4.14], respectively; and ORs for 13-18 years, 2.37 [95% CI, 1.20-4.66] and 1.89 [95% CI, 1.11-3.24], respectively) and those with a preexisting comorbidity (ORs, 1.90 [95% CI, 1.10-3.29] and 1.76 [95% CI, 1.14-2.69], respectively). In this secondary analysis of a cluster randomized trial, 2 in 3 children hospitalized for acute respiratory failure missed school after discharge, for a median duration of nearly 2 weeks. In addition, more than half of primary caregivers missed work after discharge. The magnitude of school absenteeism suggests that children may be at increased risk for lower educational achievement, economic hardship, and poor health outcomes in adulthood.
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影响因子：
3.7
作者：
Bortes, Cristian;Strandh, Mattias;Nilsson, Karina
通讯作者：
Nilsson, Karina
影响因子：
3.6
作者：
Kohler-Forsberg, Ole;Sorensen, Holger J.;Petersen, Liselotte
通讯作者：
Petersen, Liselotte
影响因子：
8.3
作者：
Natale, JoAnne E.;Asaro, Lisa A.;Curley, Martha A. Q.
通讯作者：
Curley, Martha A. Q.
影响因子：
3.1
作者：
Clark, Maureen E.;Cummings, Brian M.;Noviski, Natan
通讯作者：
Noviski, Natan
影响因子：
16.2
作者：
McCarthy, AM;Lindgren, S;Engvall, J
通讯作者：
Engvall, J