Behaviour Concerns in Preschool Cardiac Surgery Survivors.

Autor: Eliason SHY; Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.; Complex Pediatric Therapies Follow-Up Program, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada., Robertson CMT; Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.; Complex Pediatric Therapies Follow-Up Program, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada., Bobbitt SA; Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada., Khademioureh S; School of Public Health, University of Alberta, Edmonton, Alberta, Canada., Dinu IA; School of Public Health, University of Alberta, Edmonton, Alberta, Canada., Joffe AR; Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada., Acton BV; Department of Psychology and Health Studies, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Jazyk: angličtina
Zdroj: CJC pediatric and congenital heart disease [CJC Pediatr Congenit Heart Dis] 2024 Apr 26; Vol. 3 (4), pp. 141-151. Date of Electronic Publication: 2024 Apr 26 (Print Publication: 2024).
DOI: 10.1016/j.cjcpc.2024.04.001
Abstrakt: Background: Behaviour concerns (BC) are reported in survivors of complex cardiac surgery (CCSx) with inconsistent evidence about health and demographic variables that impact outcomes.
Methods: A prospective inception-cohort study of infants (without known chromosomal abnormalities) after CCSx from 2001 to 2017 determined Behaviour Assessment System for Children (BASC-II/III) parent rating scales at 4.5 years. T scores ≥60 for externalizing, internalizing, and the Behavioural Symptoms Index and ≤40 for adaptive behaviour defined BC. Potential predictive variables included demographic, acute care, and health factors after initial CCSx. Multiple logistic regression using the purposeful selection method gave odds ratios (ORs) with 95% confidence intervals (CIs).
Results: Survivors (n = 585; 61% boys, 40% single ventricle) were assessed at a median age of 55 months (interquartile range: 53, 57 months). Independent predictors were noncardiac hospitalizations (OR: 1.10, 95% CI: 1.02, 1.19; P  = 0.015) for externalizing; noncardiac hospitalizations (OR: 1.14, 95% CI: 1.05, 1.24; P  = 0.003), female sex (OR: 1.62, 95% CI: 1.04, 2.52; P  = 0.031), and single ventricle (OR: 1.82, 95% CI: 1.04, 3.17; P  = 0.035) for internalizing; noncardiac hospitalizations (OR: 1.10, 95% CI: 1.02, 1.19; P  = 0.017), socioeconomic status (SES) (OR: 0.98, 95% CI: 0.96, 0.10; P  = 0.031), and years of maternal schooling (OR: 0.91, 95% CI: 0.84, 0.10; P  = 0.04) for adaptive; and extracorporeal life-saving support (OR: 2.03, 95% CI: 1.01, 3.96; P  = 0.041) for the Behavioural Symptoms Index, indicating more pervasive behaviours.
Conclusions: The number of noncardiac hospitalizations predicted increased odds of BC and requires further attention. Improving inpatient trauma-informed care experiences and optimizing access to primary care to prevent noncardiac hospitalization may be modifiable.
(© 2024 The Authors.)
Databáze: MEDLINE
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