A systematic review of the impact of intensive care admissions on post discharge cognition in children

A.S.M. Royer, J.O. Busari*

*Corresponding author for this work

Research output: Contribution to journal(Systematic) Review article peer-review


Understanding how hospitalization affects cognitive development is crucial to safeguard children's cognition; however, there is little research evaluating the associations between NICU or PICU hospitalization and survivors' cognition. The objective of this study is to identify and characterize the associations between a neonatal or pediatric ICU hospitalization and the short- and longterm cognition of survivors. The databases Cochrane Library, Medline, EBSCO, Embase, and Google Scholar and the journals JAMA Pediatrics, Journal of Pediatrics, Pediatrics, Archives of Disease in Childhood, Academic Pediatrics, Pediatric Critical Care Medicine and Child Development were searched until April 2021. Retrieved article references were analyzed. Included articles investigated cognition as an outcome of ICU hospitalization in non-preterm neonatal or pediatric patients. Case studies and studies analyzing diagnosis or treatment interventions were excluded. Four prospective cohort or case-control studies and two retrospective cohort studies were included, totaling 2172 neonatal and 42368 pediatric patients. Quality assessment using the BMJ Criteria and Cochrane Collaboration's Risk-of-Bias tool displayed good results. Significant negative associations were found between neonatal cognition and length-of-ICU-stay at 9- (p<0.001) and 24 months (p<0.01), and between pediatric cognition and length-of-ICU-stay at discharge (p<0.001). Additional weeks on the neonatal ICU increased odds of impairment at 9- (OR 1.08, 95%CI 1.034-1.112) and 24 months (OR 1.11, 95%CI 1.065-1.165).Conclusion: There is a significant negative correlation between NICU and PICU hospitalization and the short- and long-term cognitive status. Future research must identify patient- and hospital-related risk factors and develop management strategies.
Original languageEnglish
Pages (from-to)3443-3454
Number of pages12
JournalEuropean Journal of Pediatrics
Issue number12
Early online date11 Jun 2021
Publication statusPublished - Dec 2021


  • Cognition
  • Cognitive development
  • PICU (hospitalization)
  • NICU (hospitalization)
  • Post-discharge
  • Systematic development
  • UNIT


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