Steven Shein, MD, FCCM
Rainbow Babies & Children's Hospital
Cleveland, Ohio
Disclosure information not submitted.
Alena Sorensen, BA
Data Coordinator
Case Western Reserve University Mandel School of Applied Social Sciences, United States
Disclosure information not submitted.
Meredith Fischer, MA
Medical Student
Case Western Reserve University School of Medicine, United States
Disclosure information not submitted.
Stephen Steh, MS, MA
Research Associate
Case Western Reserve University Mandel School of Applied Social Sciences, United States
Disclosure information not submitted.
Francisca Richter, PhD
Research Assistant Professor
Case Western Reserve University Mandel School of Applied Social Sciences, United States
Disclosure information not submitted.
Title: Kindergarten Readiness Assessment Scores after Mechanical Ventilation in the PICU Before Age Three
Introduction: Exposure to general anesthesia early in life has been associated with poor school performance. Children receiving invasive mechanical ventilation (MV) in the PICU often receive other GABA-ergic medications (e.g. benzodiazapines) for multiple days, but the association between receiving early-life MV in the PICU and later school performance has not been well described.
Methods: Children born in 2011 or 2012 who received MV in our PICU before age 3 years were identified. Demographic data were collected and used to match patients to records in our University’s Child and Household Integrated Longitudinal Data (CHILD) System. CHILD collates data from over 35 administrative systems, including several Cuyahoga County social services agencies and local school districts. Factors of interest for this work include public assistance receipt and Kindergarten Readiness Assessment (KRA) scores. Descriptive analyses are reported.
Results: Among 181 children who received early life MV in our PICU, 99 (56%) were matched to CHILD records. Two matched children died between PICU discharge and age 5, and were excluded. Utilization of public assistance was common among the remaining 97 children, including Food Stamps (SNAP; 70%) and Cash Assistance (TANF; 25%) for ≥1 month before age five. By this age, 41% of identified children had ≥1 contact with the Department of Child and Family Services.
Among 48 subjects with a kindergarten record in CHILD, 44% were chronically absent that year (missed ≥10% of enrolled days). Forty children (83%) underwent KRA testing in a school district tracked in CHILD. Among these children, only 23% received a language and literacy score considered “on track” for age.
Conclusions: Linking hospital electronic health records to an integrated public services database is feasible and can support continued research. In this preliminary study, a quarter of children who received MV before the age three in our PICU had standardized kindergarten test scores available. Of these children, more than three-quarters did not have language and literacy skills on track for their age group. Further work is needed to evaluate if early-life receipt of GABA-ergic agents is a modifiable risk factor for poor school performance.