TY - JOUR
AU - R. E. Hay
AU - K. O'Hearn
AU - D. J. Zorko
AU - L. A. Lee
AU - S. Mooney
AU - C. McQuaid
AU - L. Albrecht
AU - D. E. Henshall
AU - V. C. Dannenberg
AU - V. Flamenghi
AU - C. Thibault
AU - W. K. Lee
AU - Shi Min Ko
AU - M. Cree
AU - J. St Louis
AU - J. A. Heneghan
AU - K. K. Y. Leung
AU - A. Wood
AU - E. López-Barón
AU - M. H. Temsah
AU - M. Almazyad
AU - J. Retallack
AU - M. Reddy
AU - N. Aldairi
AU - R. E. L. Palomino
AU - K. Choong
AU - Du Pont-Thibodeau
AU - L. Ducharme-Crevier
AU - A. Tsampalieros
AU - L. Hayawi
AU - J. D. M. McNally
AU - Garcia Guerra
A1 - 
AB - OBJECTIVES: In survivors of illnesses or surgeries requiring PICU admission, there is a risk of posttraumatic stress disorder (PTSD). We aimed to estimate PTSD prevalence and potential contributing factors in survivors of PICU admission. DATA SOURCES: We performed a PROSPERO registered systematic review (CRD42022348997; Registered August 2022) using MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases, 2000 to 2022, with no language restrictions. STUDY SELECTION: Observational or interventional studies evaluating the incidence or prevalence of PTSD in patients' after PICU admission and/or contributing factors to PTSD. We used studies describing patients younger than 18 years old. Since there were a large number of citations, we used an integrated crowdsourcing and machine-learning model for citation screening. Each citation was reviewed independently and in duplicate by two reviewers at each stage of screening and abstraction. DATA EXTRACTION: Data items included study and participant demographics, details of case definition (PTSD screening), and risk factors. DATA SYNTHESIS: We followed the Preferred Reporting items for Systematic Reviews and Meta-analysis guidelines. Random-effects models were used to analyze PTSD prevalence and subgroup differences. In 24 citations meeting final review criteria, 19 had data for meta-analysis. There were 1898 PICU survivors with a median (interquartile range) cohort size of 59 (49-76). PTSD prevalence in the studies ranged from 3% to 37%; PTSD occurred in 529 of 1898 survivors ( I2 = 72%). Factors influencing PTSD variability included timing of assessment ( p < 0.01) with the highest prevalence (29%) at 6 months and the type of assessment instrument ( n = 10; range, 4-27%; p = 0.04). There was lower prevalence of PTSD (8%) in postoperative cardiac patients ( p < 0.01). Last, we failed to find an association between PICU length of stay and PTSD prevalence ( p = 0.62; I2 = 80%). CONCLUSIONS: PICU follow-up studies from 2000 to 2022 indicate that one-in-three of admissions surviving to 6 months have PTSD. However, there are population, study design factors and heterogeneity in PTSD assessment that indicate more standardization in this research is needed.
AD - Department of Pediatric Critical Care, University of Ottawa, Ottawa, ON, Canada.; Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.; Department of Pediatrics, Division of Pediatric Critical Care, McMaster University, Hamilton, ON, Canada.; Department of Pediatrics, Cumming School of Medicine and Faculty of Nursing, University of Calgary, Calgary, AB, Canada.; Stollery Children's Hospital, Alberta Health Services, Calgary, AB, Canada.; Deanery of Clinical Sciences, College of Medicine & Veterinary Medicine, The University of Edinburgh, Edinburgh, United Kingdom.; Department of Pediatrics, Division of Pediatric Respiratory Medicine, University of Alberta, Edmonton, AB, Canada.; Department of Pediatrics, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.; Department of Pediatrics, Division of Pediatric Critical Care Medicine, CHU Sainte-Justine, Montreal, QC, Canada.; College of Clinical Medicine, Singapore Health Services (Singhealth), Singapore.; Pharmacy Department, University of Queensland Centre for Clinical Research, Queensland Children's Hospital, Brisbane, QLD, Australia.; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.; Department of Pediatrics, Division of Pediatric Critical Care, University of Minnesota, Minneapolis, MN.; Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong, China.; Physiotherapy Department RHCYP NHS Lothian, Edinburgh, United Kingdom.; Pediatric Critical Care, Hospital Pablo Tobón Uribe, Universidad de Antioquia, Medellín, Colombia.; Pediatric Intensive Care Unit, Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.; Division Critical Care, BC Children's Hospital, Vancouver, BC, Canada.; Department of Pediatrics, All India Institute of Medical Sciences Bibinagar, Hyderabad, India.; Pediatric Critical Care Department, Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia.; Department of Intensive and Intermediate Pediatric Care, ICESI University, Fundación Valle del Lili, Cali, Colombia.; Department of Pediatrics, Division of Critical Care, University of Calgary, Calgary, AB, Canada.
AN - 39932370
BT - Pediatr Crit Care Med
C5 - Healthcare Disparities
CP - 4
DA - Apr 1
DO - 10.1097/pcc.0000000000003696
DP - NLM
ET - 20250211
IS - 4
JF - Pediatr Crit Care Med
LA - eng
N2 - OBJECTIVES: In survivors of illnesses or surgeries requiring PICU admission, there is a risk of posttraumatic stress disorder (PTSD). We aimed to estimate PTSD prevalence and potential contributing factors in survivors of PICU admission. DATA SOURCES: We performed a PROSPERO registered systematic review (CRD42022348997; Registered August 2022) using MEDLINE, Embase, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases, 2000 to 2022, with no language restrictions. STUDY SELECTION: Observational or interventional studies evaluating the incidence or prevalence of PTSD in patients' after PICU admission and/or contributing factors to PTSD. We used studies describing patients younger than 18 years old. Since there were a large number of citations, we used an integrated crowdsourcing and machine-learning model for citation screening. Each citation was reviewed independently and in duplicate by two reviewers at each stage of screening and abstraction. DATA EXTRACTION: Data items included study and participant demographics, details of case definition (PTSD screening), and risk factors. DATA SYNTHESIS: We followed the Preferred Reporting items for Systematic Reviews and Meta-analysis guidelines. Random-effects models were used to analyze PTSD prevalence and subgroup differences. In 24 citations meeting final review criteria, 19 had data for meta-analysis. There were 1898 PICU survivors with a median (interquartile range) cohort size of 59 (49-76). PTSD prevalence in the studies ranged from 3% to 37%; PTSD occurred in 529 of 1898 survivors ( I2 = 72%). Factors influencing PTSD variability included timing of assessment ( p < 0.01) with the highest prevalence (29%) at 6 months and the type of assessment instrument ( n = 10; range, 4-27%; p = 0.04). There was lower prevalence of PTSD (8%) in postoperative cardiac patients ( p < 0.01). Last, we failed to find an association between PICU length of stay and PTSD prevalence ( p = 0.62; I2 = 80%). CONCLUSIONS: PICU follow-up studies from 2000 to 2022 indicate that one-in-three of admissions surviving to 6 months have PTSD. However, there are population, study design factors and heterogeneity in PTSD assessment that indicate more standardization in this research is needed.
PY - 2025
SN - 1529-7535 (Print); 1529-7535
SP - e531
EP - e543+
ST - Systematic Review and Meta-Analysis of Prevalence and Population-Level Factors Contributing to Posttraumatic Stress Disorder in Pediatric Intensive Care Survivors
T1 - Systematic Review and Meta-Analysis of Prevalence and Population-Level Factors Contributing to Posttraumatic Stress Disorder in Pediatric Intensive Care Survivors
T2 - Pediatr Crit Care Med
TI - Systematic Review and Meta-Analysis of Prevalence and Population-Level Factors Contributing to Posttraumatic Stress Disorder in Pediatric Intensive Care Survivors
U1 - Healthcare Disparities
U3 - 10.1097/pcc.0000000000003696
VL - 26
VO - 1529-7535 (Print); 1529-7535
Y1 - 2025
ER -