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Functional health status in children following surgery for congenital heart disease: a population-based cohort study

Published online by Cambridge University Press:  12 July 2010

Signe H. Larsen ,
Brian W. McCrindle ,
Elisabeth B. Jacobsen ,
Søren P. Johnsen ,
Kristian Emmertsen  and
Vibeke E. Hjortdal
Signe H. Larsen*
Affiliation:
Department of Cardiothoracic Surgery, Aarhus University Hospital – Skejby, Aarhus, Denmark
Brian W. McCrindle
Affiliation:
Congenital Heart Surgeons Society Data Center and Division of Cardiology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
Elisabeth B. Jacobsen
Affiliation:
Department of Cardiothoracic Surgery, Aarhus University Hospital – Skejby, Aarhus, Denmark
Søren P. Johnsen
Affiliation:
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
Kristian Emmertsen
Affiliation:
Department of Cardiology, Aarhus University Hospital – Skejby, Aarhus, Denmark
Vibeke E. Hjortdal
Affiliation:
Department of Cardiothoracic Surgery, Aarhus University Hospital – Skejby, Aarhus, Denmark
*
Correspondence to: S. H. Larsen, MD, PhD, Department of Cardiothoracic Surgery, Aarhus University Hospital – Skejby, Brendstrupgaardsvej, 8200 Aarhus N, Denmark. Tel: +45 89495486; Fax: +45 89496016; E-mail: [email protected]
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Abstract

Background

Functional health is becoming an important part of outcome assessment following congenital heart surgery.

Methods

The Child Health Questionnaire was used to evaluate self-reported functional health in a cohort of children operated on for congenital heart disease between 1996 and 2002, now aged 10–20 years. A total of 288 schoolchildren served as controls. The association between demographic and clinical factors such as the Risk Adjusted Classification for Congenital Heart Surgery, the Aristotle Basic Complexity Score, physical and psycho-social domains was explored by multivariate analysis.

Results

In total 239 children who were operated on (response rate 68%, mean age at assessment 13.1 years, 50% male children) participated. There were no differences between children operated on for congenital heart disease and controls in nine out of thirteen domains. In multivariate analysis, male gender was positively associated with physical, mental and general health. Higher education of the parents was also associated with better scores for family activities, physical, emotional and general health. In contrast, living with a single parent was negatively associated with mental health. Category 4 in the Risk Adjusted Classification for Congenital Heart Surgery was associated with worse scores in all behaviour domains. The Aristotle Basic Complexity Score was not associated with any domain.

Conclusion

Functional health in children operated for congenital heart disease was overall similar to other children of the same age. Male gender of the child, education of the parents, living with a single parent, and category 4 in the Risk Adjusted Classification for Congenital Heart Surgery were important factors for functional health.

Keywords

Congenital heart defectsoutcomesrisk factorsquestionnairefollow-up studies
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 6 , December 2010 , pp. 631 - 640
Copyright
Copyright © Cambridge University Press 2010

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References

1. Spijkerboer, AW, Utens, EM, De Koning, WB, Bogers, AJ, Helbing, WA, Verhulst, FC. Health-related quality of life in children and adolescents after invasive treatment for congenital heart disease. Qual Life Res 2006; 15: 663–673.Google Scholar
2. McCrindle, BW, Williams, RV, Mitchell, PD, et al. Relationship of patient and medical characteristics to health status in children and adolescents after the Fontan procedure. Circulation 2006; 113: 1123–1129.CrossRefGoogle ScholarPubMed
3. Landolt, MA, Valsangiacomo Buechel, ER, Latal, B. Health-related quality of life in children and adolescents after open-heart surgery. J Pediatr 2008; 152: 349–355.CrossRefGoogle ScholarPubMed
4. Ekman-Joelsson, BM, Berntsson, L, Sunnegardh, J. Quality of life in children with pulmonary atresia and intact ventricular septum. Cardiol Young 2004; 14: 615–621.CrossRefGoogle ScholarPubMed
5. Hovels-Gurich, HH, Konrad, K, Wiesner, M, et al. Long term behavioural outcome after neonatal arterial switch operation for transposition of the great arteries. Arch Dis Child 2002; 87: 506–510.CrossRefGoogle ScholarPubMed
6. Culbert, EL, Ashburn, DA, Cullen-Dean, G, et al. Quality of life of children after repair of transposition of the great arteries. Circulation 2003; 108: 857–862.CrossRefGoogle ScholarPubMed
7. Latal, B, Helfricht, S, Fischer, JE, Bauersfeld, U, Landolt, 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: 6.CrossRefGoogle ScholarPubMed
8. Pike, NA, Evangelista, LS, Doering, LV, Koniak-Griffin, D, Lewis, AB, Child, JS. Health-related quality of life: a closer look at related research in patients who have undergone the Fontan operation over the last decade. Heart Lung 2007; 36: 3–15.CrossRefGoogle Scholar
9. Pedersen, CB, Gotzsche, H, Moller, JO, Mortensen, PB. The Danish Civil Registration System. A cohort of eight million persons. Dan Med Bull 2006; 53: 441–449.Google Scholar
10. Andersen, TF, Madsen, M, Jorgensen, J, Mellemkjoer, L, Olsen, JH. The Danish National Hospital Register. A valuable source of data for modern health sciences. Dan Med Bull 1999; 46: 263–268.Google Scholar
11. Landgraf, JM, Abetz, L, Ware, JE. Child Health Questionnaire (CHQ): A User’s Manual. The Health Institute, New England Medical Center, Boston, 1996.Google Scholar
12. Jacobsen, EB, Thastum, M, Jeppesen, JH, Pilegaard, H. Health-related quality of life in children and adolescents undergoing surgery for pectus excavatum. Eur J Pediatr Surg 2010; 20: 85–91.Google Scholar
13. Jenkins, KJ, Gauvreau, K, Newburger, JW, Spray, TL, Moller, JH, Iezzoni, LI. Consensus-based method for risk adjustment for surgery for congenital heart disease. J Thorac Cardiovasc Surg 2002; 123: 110–118.CrossRefGoogle ScholarPubMed
14. Boethig, D, Jenkins, KJ, Hecker, H, Thies, WR, Breymann, T. The RACHS-1 risk categories reflect mortality and length of hospital stay in a large German pediatric cardiac surgery population. Eur J Cardiothorac Surg 2004; 26: 12–17.Google Scholar
15. Larsen, SH, Pedersen, J, Jacobsen, J, Johnsen, SP, Hansen, OK, Hjortdal, V. The RACHS-1 risk categories reflect mortality and length of stay in a Danish population of children operated for congenital heart disease. Eur J Cardiothorac Surg 2005; 28: 877–881.CrossRefGoogle Scholar
16. Lacour-Gayet, F, Clarke, D, Jacobs, J, et al. The Aristotle score: a complexity-adjusted method to evaluate surgical results. Eur J Cardiothorac Surg 2004; 25: 911–924.CrossRefGoogle Scholar
17. Smith, KW, Avis, NE, Assmann, SF. Distinguishing between quality of life and health status in quality of life research: a meta-analysis. Qual Life Res 1999; 8: 447–459.Google Scholar
18. De, CM, Regier, D, Alamgir, AH, Anis, AH, Fitzgerald, MJ, Marra, CA. Evaluating health-related quality-of-life studies in paediatric populations: some conceptual, methodological and developmental considerations and recent applications. Pharmacoeconomics 2005; 23: 659–685.Google Scholar
19. Marino, BS, Shera, D, Wernovsky, G, et al. The development of the pediatric cardiac quality of life inventory: a quality of life measure for children and adolescents with heart disease. Qual Life Res 2008; 17: 613–626.Google Scholar
20. Lewis, CC, Pantell, RH, Kieckhefer, GM. Assessment of children’s health status. Field test of new approaches. Med Care 1989; 27: S54–S65.Google Scholar
21. van der Rijken, RE, Maassen, BA, Walk, TL, Daniels, O, Hulstijn-Dirkmaat, GM. Outcome after surgical repair of congenital cardiac malformations at school age. Cardiol Young 2007; 17: 64–71.Google Scholar
22. Noll, RB, Kozlowski, K, Gerhardt, C, Vannatta, K, Taylor, J, Passo, M. Social, emotional, and behavioral functioning of children with juvenile rheumatoid arthritis. Arthritis Rheum 2000; 43: 1387–1396.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
23. Noll, RB, Gartstein, MA, Vannatta, K, Correll, J, Bukowski, WM, Davies, WH. Social, emotional, and behavioral functioning of children with cancer. Pediatrics 1999; 103: 71–78.CrossRefGoogle ScholarPubMed
24. Dunbar-Masterson, C, Wypij, D, Bellinger, DC, et al. General health status of children with D-transposition of the great arteries after the arterial switch operation. Circulation 2001; 104: I138–I142.CrossRefGoogle ScholarPubMed
25. Williams, DL, Gelijns, AC, Moskowitz, AJ, et al. Hypoplastic left heart syndrome: valuing the survival. J Thorac Cardiovasc Surg 2000; 119: 720–731.Google Scholar
26. Raat, H, Landgraf, JM, Bonsel, GJ, Gemke, RJ, Essink-Bot, ML. Reliability and validity of the child health questionnaire-child form (CHQ-CF87) in a Dutch adolescent population. Qual Life Res 2002; 11: 575–581.Google Scholar
27. Raat, H, Mangunkusumo, RT, Landgraf, JM, Kloek, G, Brug, J. Feasibility, reliability, and validity of adolescent health status measurement by the Child Health Questionnaire Child Form (CHQ-CF): internet administration compared with the standard paper version. Qual Life Res 2007; 16: 675–685.CrossRefGoogle ScholarPubMed