Neurodevelopmental and Behavioral Outcomes in Children With Sepsis-Associated Encephalopathy Admitted to Pediatric Intensive Care Unit: A Prospective Case Control Study

J Child Neurol. 2016 May;31(6):683-90. doi: 10.1177/0883073815610431. Epub 2015 Oct 23.

Abstract

The authors prospectively compared the neurodevelopmental and behavioral outcomes in 50 consecutive children with sepsis-associated encephalopathy admitted to intensive care unit with healthy controls. Children with sepsis-associated encephalopathy had significantly worse mean verbal IQ, full-scale IQ, General Development Score, and its physical, adaptive, social-emotional, cognitive, and communication subscales. Significant proportion of cases (52% vs 32% in controls) had low intelligence. Decline in school performance (44%), disobedience (28%), and stubbornness/irritable behavior (26%) were the most common behavior changes. Children with Glasgow Coma Scale score ≤10 and ≤8 had impairments in full-scale IQ even though overall Glasgow Coma Scale score did not show significant correlation with developmental outcomes. In conclusion, children with sepsis-associated encephalopathy have delayed neurodevelopment, low verbal IQ, decline in school performance and low intelligence at short-term follow-up. Irritability, shock and duration of sedation are associated with poor behavioral outcomes, especially scholastic performance.

Keywords: behavioral; neurodevelopmental; pediatric intensive care; sepsis-associated encephalopathy.

MeSH terms

  • Age Factors
  • Analysis of Variance
  • Case-Control Studies
  • Child
  • Child Behavior Disorders / etiology*
  • Child, Preschool
  • Cognition Disorders / etiology*
  • Developmental Disabilities / etiology*
  • Female
  • Humans
  • Intellectual Disability / diagnosis
  • Intellectual Disability / etiology
  • Intelligence Tests
  • Intensive Care Units, Pediatric*
  • Male
  • Neuropsychological Tests
  • Prospective Studies
  • Sepsis-Associated Encephalopathy / complications*
  • Severity of Illness Index
  • Verbal Behavior