School Functioning and Cognitive Fatigue in Survivors of Pediatric Sepsis: An Exploratory Study

Sunday, March 22, 2026

12:15 PM - 1:15 PM Central Time

Location: Connections Central - RST 17

AA

Alicia Alcamo, MD, MPH

The Children's Hospital of Philadelphia

Disclosure(s): Edwards Lifesciences: Contracted Research (Principal Investigators must provide information, even if received by the institution) (Terminated, October 1, 2025)
SD

Shawn Dickey, MHA

Research Coordinator
Children's Hospital of Philadelphia

Disclosure information not submitted.
NT

Nina Thomas, PhD, ABPP-Cn

Associate Professor
Children's Hospital of Philadelphia

Disclosure information not submitted.
BS

Beth Slomine, PhD, ABPP

Professor
Kennedy Krieger Insitute, Johns Hopkins

Disclosure information not submitted.
Scott L. Weiss, MD, FCCM

Nemours Childrens Hospital
Sidney Kimmel Medical Center at Thomas Jefferson University, Pennsylvania

Disclosure information not submitted.
NP

Neethi Pinto, MD

Associate Professor
Children's Hospital of Philadelphia

Disclosure information not submitted.
AT

Alexis Topjian, MD, FCCM, MSCE

Professor
Childrens Hospital of Philadelphia, Pennsylvania

Disclosure information not submitted.
JF

Julie C. Fitzgerald, MD, PhD, MSCE, FCCM

The Children's Hospital of Philadelphia, Pennsylvania

Disclosure(s): No relevant financial relationship(s) to disclose.

Introduction: Children are at increased risk for new neurocognitive morbidities after sepsis, including memory and attention problems, but school function following hospital discharge is not well described. We hypothesized that children with new school concerns during follow-up are more likely to have decreased school functioning and cognitive fatigue.

Methods: We conducted a prospective cohort study of school-aged children admitted to the ICU from Jan 2022-Nov 2024 with sepsis or septic shock. We included English or Spanish-speaking children < 17 years old who attended school at enrollment, had admission Pediatric Overall Performance Category (POPC) ≤ 3, and were expected to survive hospitalization. Parents completed a survey asking about new school concerns (including report of teacher concerns) and the PedsQL Generic Core school functioning and Fatigue Scale cognitive fatigue subscales at enrollment (pre-illness baseline) and 1-, 3-, and 6-months post-discharge. Children were included in the analysis if data from ≥1 follow-up timepoint were available. Data are reported as percentages or median [IQR] and compared using chi-squared or Wilcoxon rank-sum tests.

Results: Of 48 children enrolled, 41 (85%) completed ≥1 follow-up survey. Response rates were 66%, 76% and 56% at 1-, 3-, and 6-months, respectively. Among those with follow-up, median age was 10y [6,14], 56% male, 49% previously healthy, 73% POPC of 1 (age-appropriate) at admission. Four children (10%) did not return to school within 6 months. Of those who did, 14/37 (38%) had new school concerns reported. Children with new school concerns had lower median school functioning scores at 3 months (55 [50,68] vs 80 [60,95], p=0.04) and 6 months (55 [50,70] vs 90 [80,95], p=0.01) and lower cognitive fatigue scores at all timepoints (1mo: 68 [50,79] vs 96 [71,100], p=0.005; 3mo: 50 [50,75] vs 98 [75,100], p< 0.001; 6mo: 50 [50,75] vs 100 [96,100], p=0.002) compared to those who returned to school without new concerns.

Conclusions: Ten percent of sepsis survivors did not return to school in the 6 months after discharge. One-third of those who returned to school had new concerns, which were associated with lower school functioning and greater cognitive fatigue. Further study is needed to determine how these measures are associated with school performance.