Outcomes of critically ill children with pre-existing mental health conditions

Importance:Critically ill children with pre-existing mental health conditions may have an increased risk of poor health outcomes.Objective:We aimed to evaluate if pre-existing mental health conditions in critically ill pediatric patients would be associated with worse clinical outcomes,compared to children with no documented mental health conditions.Methods:This retrospective observational cohort study utilized the TriNetX electronic health record database of critically ill subjects aged 12-18 years.Data were analyzed for demographics,pre-existing conditions,diagnostic,medication,procedural codes,and mortality.Results:From a dataset of 102027 critically ill children,we analyzed 1999 subjects(284[14.2%]with a pre-existing mental health condition and 1715[85.8%]with no pre-existing mental health condition).Multivariable analysis demonstrated that death within one year was associated with the presence of pre-existing mental health conditions(odds ratio 8.97[3.48-23.15],P<0.001),even after controlling for the presence of a complex chronic condition.Interpretation:The present study demonstrates that the presence of pre-existing mental health conditions was associated with higher odds of death within 1 year after receiving critical care.However,the confidence interval was wide and hence,the findings are inconclusive.Future studies with a larger sample size may be necessary to evaluate the true long-term impact of children with pre-existing mental health conditions who require critical care services.