Impact of Surgical Complexity on Health‐Related Quality of Life in Congenital Heart Disease Surgical Survivors

Autor: Dennis Drotar, Gil Wernovsky, Katherine L Brown, Ryan S. Tomlinson, Richard F. Ittenbach, Kathy J. Jenkins, Rodney C. G. Franklin, Lynn Mahony, Amy Cassedy, Bradley S. Marino, Jo Wray, Jane W. Newburger, Amy M. O'Connor, Kathleen A. Mussatto, Jeffrey P. Jacobs
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Aristotle Basic Complexity
Heart Defects
Congenital
Male
medicine.medical_specialty
Pediatrics
Heart disease
Adolescent
Databases
Factual
Health Status
Population
Therapeutics
030204 cardiovascular system & hematology
Affect (psychology)
Risk Adjustment in Congenital Heart Surgery
03 medical and health sciences
0302 clinical medicine
Quality of life
Risk Factors
030225 pediatrics
Clinical Studies
medicine
Raw score
Humans
Survivors
Cardiac Surgical Procedures
education
Child
Original Research
education.field_of_study
Quality and Outcomes
Cardiovascular Surgery
business.industry
Congenital Heart Disease
congenital heart disease surgery
medicine.disease
humanities
United Kingdom
United States
Cardiac surgery
El Niño
quality of life
Great arteries
Physical therapy
Female
Cardiology and Cardiovascular Medicine
business
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
Popis: Background Surgical complexity and related morbidities may affect long‐term patient quality of life ( QOL ). Aristotle Basic Complexity ( ABC ) score and Risk Adjustment in Congenital Heart Surgery ( RACHS ‐1) category stratify the complexity of pediatric cardiac operations. The purpose of this study was to examine the relationship between surgical complexity and QOL and to investigate other demographic and clinical variables that might explain variation in QOL in pediatric cardiac surgical survivors. Methods and Results Pediatric Cardiac Quality of Life ( PCQLI ) study participants who had undergone cardiac surgery were included. The PCQLI database provided sample characteristics and QOL scores. Surgical complexity was defined by the highest ABC raw score or RACHS ‐1 category. Relationships among surgical complexity and demographic, clinical, and QOL variables were assessed using ordinary least squares regression. A total of 1416 patient–parent pairs were included. Although higher ABC scores and RACHS ‐1 categories were associated with lower QOL scores ( P QOL scores was poor to fair ( r =−0.10 to −0.29) for all groups. Ordinary least squares regression showed weak association with R 2 =0.06 to R 2 =0.28. After accounting for single‐ventricle anatomy, number of doctor visits, and time since last hospitalization, surgical complexity scores added no additional explanation to the variance in QOL scores. Conclusions ABC scores and RACHS ‐1 categories are useful tools for morbidity and mortality predictions prior to cardiac surgery and quality of care initiatives but are minimally helpful in predicting a child's or adolescent's long‐term QOL scores. Further studies are warranted to determine other predictors of QOL variation.
Databáze: OpenAIRE
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