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Corinne M. P. Buysse, MD; Hein Raat, PhD; Jan A. Hazelzet, PhD; Jessie M. Hulst, PhD; Karlien Cransberg, PhD; Wim C. J. Hop, PhD; Lindy C. A. C. Vermunt, MSc; Elisabeth M. W. J. Utens, PhD; Marianne Maliepaard, RN; Koen F. M. Joosten, PhD

Arch Pediatr Adolesc Med. 2008;162(11):1036-1041.

Objective  To assess long-term health status in patients who survived meningococcal septic shock in childhood.

Design  Medical and psychological follow-up of a cross-sectional cohort.

Setting  Pediatric intensive care unit (PICU) of a tertiary care university hospital.

Participants  All consecutive patients with septic shock and purpura who required intensive care between 1988 and 2001.

Intervention  Patients and their parents were invited to our follow-up clinic 4 to 16 years after PICU discharge.

Outcome Measures  Health status was assessed with a standard medical interview, physical examination, renal function test, and the Health Utilities Index Mark 2 (HUI2) and 3 (HUI3).

Results  One hundred twenty patients (response rate 71%) participated in the follow-up (median age at PICU admission, 3.1 years; median follow-up interval, 9.8 years; median age at follow-up, 14.5 years). Thirty-five percent of patients had 1 or more of the following neurological impairments: severe mental retardation with epilepsy (3%), hearing loss (2%), chronic headache (28%), and focal neurological signs (6%), like paresis of 1 arm. One of the 16 patients with septic shock–associated acute renal failure at PICU admission showed signs of mild chronic renal failure (glomerular filtration rate, 62 mL/min/1.73m²; proteinuria; and hypertension). Scores were significantly lower on nearly all HUI2 and HUI3 attributes compared with Dutch population data, indicating poorer health in these patients.

Conclusions  In patients who survived meningococcal septic shock in childhood, one-third showed long-term neurological impairments, ranging from mild to severe and irreversible. Patients reported poorer general health as measured by HUI2 and HUI3.

Author Affiliations: Department of Paediatrics, Division of Paediatric Intensive Care (Drs Buysse, Hazelzet, Hulst, and Joosten and Ms Maliepaard), Department of Public Health (Dr Raat), Department of Paediatrics, Division of Paediatric Nephrology (Dr Cransberg), Department of Epidemiology and Biostatistics (Dr Hop), and Department of Child and Adolescent Psychiatry (Ms Vermunt and Dr Utens), Erasmus MC–Sophia Children's Hospital, Rotterdam, the Netherlands.

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