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Children with hypoplastic left heart syndrome have lower quality of life than healthy controls and children with other illnesses

Published online by Cambridge University Press:  29 August 2017

Nicole Dempster*
Affiliation:
Nationwide Children’s Hospital Columbus, Ohio, United States of America
Clifford L Cua
Affiliation:
Nationwide Children’s Hospital Columbus, Ohio, United States of America
Gil Wernovsky
Affiliation:
Miami, Florida, United States of America
Elizabeth Caris
Affiliation:
Nationwide Children’s Hospital Columbus, Ohio, United States of America
Trent Neely
Affiliation:
Nationwide Children’s Hospital Columbus, Ohio, United States of America
Robin Allen
Affiliation:
Nationwide Children’s Hospital Columbus, Ohio, United States of America
Catherine Butz
Affiliation:
Nationwide Children’s Hospital Columbus, Ohio, United States of America
*
Correspondence to: N. Dempster, PhD, Nationwide Children’s Hospital, 700 Childrens Drive, Columbus, OH 43205, United States of America, Tel: 614 722 4798; Fax: 614 722 4718; E-mail: [email protected]

Abstract

Objective

Previous studies suggest that children with congenital cardiac diagnoses report lower quality of life when compared with healthy norms. A few studies have evaluated quality of life specifically in children born with hypoplastic left heart syndrome, a condition requiring several surgeries before age three. The aim of this study was to use an empirically validated and standardised measure – the Pediatric Quality of Life Inventory – to evaluate quality of life in children with hypoplastic left heart syndrome and compare the findings with similar, medically complicated samples.

Methods

The parent-report Pediatric Quality of Life Inventory was administered, and demographic information was collected through an internet portal. A total of 121 caregivers of children with hypoplastic left heart syndrome responded. The sample included children aged 2–18 years (M=10.81 years). Independent sample t-tests were used to compare our sample with published norms of healthy children and children with acute or chronic illnesses.

Results

Children with hypoplastic left heart syndrome were rated as having significantly lower overall quality-of-life scores (M=59.69) compared with published norms of children without medical diagnoses (M=83.00) and those with acute (M=78.70) or chronic (M=77.19) illnesses (p<0.001). Children with hypoplastic left heart syndrome complicated by a stroke or seizure (15%) reported the lowest quality of life. The results held for all subscales (p<0.001).

Conclusions

Children with hypoplastic left heart syndrome appear to be a significantly vulnerable population with difficulties in functioning across psychosocial domains and across the age span. Further research is required to facilitate early identification of the need for resources for these children and families, especially for children who experience additional medical complications.

Type
Original Articles
Copyright
© Cambridge University Press 2017 

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References

1. Varni, JW, Seid, M, Kurtin, PS. Pediatric Quality of Life InventoryTM 4.0: Reliability and Validity of the Pediatric Quality of Life InventoryTM Version 4.0 Generic Core Scales in Healthy and Patient Populations. Med Care 2001; 39: 800812.CrossRefGoogle Scholar
2. Congenital Heart Public Health Consortium (CHPHC) of the American Academy of Pediatrics (AAP). Congenital Heart Disease Fact Sheet, 2016. Retrieved February 14, 2016, from https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/chphc/Pages/Fact-Sheet Google Scholar
3. Knowles, RL, Bull, C, Wren, C, Wade, A, Goldstein, H, Dezateux, C. Modelling survival and mortality risk to 15 years of age for a national cohort of children with serious congenital heart defects diagnosed in infancy. PLoS One 2014; 9: e106806.CrossRefGoogle ScholarPubMed
4. Mussatto, K, Tweddell, J. Quality of life following surgery for congenital cardiac malformations in neonates and infants. Cardiol Young 2005; 15: 174178.Google Scholar
5. Uzark, K, Jones, K, Slusher, J, Limbers, CA, Burwinkle, TM, Varni, JW. Quality of life in children with heart disease as perceived by children and parents. Pediatrics 2008; 121: e1060e1607.Google Scholar
6. Latal, B, Helfricht, S, Fischer, JE, Baursfeld, U, Landoldt, MA. Psychological adjustment and quality of life in children and adolescents following open-heart surgery for congenital heart disease: a systematic review. BMC Pediatr 2009; 9: 1.Google Scholar
7. Feinstein, JA, Benson, W, Dubin, AM, et al. Hypoplastic left heart syndrome: current considerations and expectations. J Am Coll Cardiol 2012; 59: S1S42.Google ScholarPubMed
8. Marino, BS, Tomlinson, RS, Wernovsky, G, et al. Validation of the pediatric cardiac quality of life inventory. Pediatrics 2010; 126: 498508.Google Scholar
9. Fruitman, DS. Hypoplastic left heart syndrome: prognosis and management options. Paediatr Child Health 2000; 5: 219225.Google Scholar
10. Goldberg, CS, Mussatto, K, Licht, D, Wernovsky, G. Neurodevelopment and quality of life for children with hypoplastic left heart syndrome: current knowns and unknowns. Cardiol Young 2011; 21 (Suppl 2): 8892.CrossRefGoogle Scholar
11. Williams, DL, Gelijns, AC, Moskowitz, AJ, et al. Hypoplastic left heart syndrome: valuing the survival. J Thorac Cardiovasc Surg 2000; 119: 720731.Google Scholar
12. Brosig, CL, Mussatto, KA, Kuhn, EM, Twedell, JS. Psychosocial outcomes for preschool children and families after surgery for complex congenital heart disease. Pediatr Cardiol 2007; 28: 255262.Google Scholar
13. Mellander, M, Berntsson, L, Nilsson, B. Quality of life in children with hypoplastic left heart syndrome. Acta Paediatr 2007; 96: 5357.CrossRefGoogle ScholarPubMed
14. Uzark, K, Zak, V, Shrader, P, et al. Assessment of quality of life in young patients with single ventricle after the Fontan operation. J Pediatr 2016; 170: 166172.Google ScholarPubMed
15. Varni, JW, Limbers, CA, Burwinkle, TM. Impaired health-related quality of life in children and adolescents with chronic conditions: a comparative analysis of 10 disease clusters and 33 disease categories/severities utilizing the Pediatric Quality of Life Inventory 4.00 Generic Core Scales. Health Qual Life Outcomes 2007; 5: 4357.Google Scholar
16. Manlhiot, C, Knezevich, S, Radojewski, E, Cullen-Dean, G, Williams, WG, McCrindle, BW. Functional health status of adolescents after the fontan procedure – comparison with their siblings. Can J Cardiol 2009; 25: e294e300.Google Scholar
17. Tabbutt, S, Nord, AS, Jarvik, GP, et al. Neurodevelopmental outcomes after staged palliation for hypoplastic left heart syndrome. Pediatrics 2008; 121: 476483.Google Scholar
18. Brosig, CL, Mussato, KA, Hoffman, G, et al. Neurodevelopmental outcomes for children with hypoplastic left heart syndrome at the age of 5 years. Pediatr Cardiol 2013; 34: 15971604.Google Scholar
19. Marino, BS, Lipkin, PH, Newburger, JW, et al. Neurodevelopmental outcomes in children with congenital heart disease: evaluation and management: a scientific statement from the American Heart Association. Circulation 2012; 126: 11431172.Google Scholar
20. Drakouli, M, Petsios, K, Giannakoupoulou, M, Patiraki, E, Voutoufianaki, I, Matzious, V. Determinants of quality of life in children and adolescents with CHD: a systematic review. Cardiol Young 2015; 25: 10271036.Google Scholar