Kindergarten Readiness Assessment Scores in Children who Received Early Life Mechanical Ventilation in the Pediatric Intensive Care Unit

Abstract

The impact of prolonged sedative medication usage on cognitive outcomes of young pediatric intensive care unit (PICU) patients has been incompletely assessed. We aim to assess the feasibility of linking an electronic medical record (EMR) system and a regional database to evaluate performance on standardized testing among PICU survivors. This is a single-center data-linkage study between EMR records and the Child and Household Integrated Longitudinal Data (CHILD) system, which links individual-level data across 35 administrative systems including Kindergarten Readiness Assessment (KRA) scores. The study was performed at a tertiary PICU in Cleveland, Ohio, United States with children born in 2011 or 2012 who received invasive mechanical ventilation and sedation before the age of 3 years in our PICU. We evaluated rate of “on-track” KRA scores, chronic absenteeism, and repeat kindergarten in the study population compared with a propensity score matched cohort from CHILD. Of 182 eligible PICU patients, 98 (54%) had a record identified in CHILD, and 32 had KRA scores available and sufficient data for propensity score matching. Compared with 160 matched controls, PICU patients had a lower rate of “on-track” scores (7/32 [22%] vs 102/160 [64%], p < 0.001) and more chronic absenteeism (14/32 [44%] vs. 34/160 [22%], p = 0.007). There was no difference in rates of repeat kindergarten (8/32 [25%] vs. 36/160 [23%], p  =  ;−0.759). We determined that linking hospital EMR records to regional databases is a feasible method to explore PICU outcomes. Additional studies are needed to confirm our preliminary finding of poor performance compared with matched controls.