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Published on: July 18, 2014
Functional health status in children following surgery for congenital heart disease: a population-based cohort study
Signe H Larsen1, Brian W McCrindle, Elisabeth B Jacobsen
1Department of Cardiothoracic Surgery, Aarhus University Hospital - Skejby, Denmark. signe_holm_larsen@hotmail.com
Insights
Children’s functional health after congenital heart surgery is similar to peers. Male gender, parental education, and family structure impact outcomes, while complex surgery may affect behavior.
Area of Science:
- Pediatric Cardiology
- Functional Health Assessment
- Congenital Heart Disease Outcomes
Background:
- Functional health is crucial for assessing outcomes after congenital heart surgery.
- Evaluating long-term functional health in pediatric patients is increasingly important.
Purpose of the Study:
- To assess self-reported functional health in children and adolescents who underwent surgery for congenital heart disease.
- To identify demographic and clinical factors associated with functional health outcomes in this cohort.
Main Methods:
- Utilized the Child Health Questionnaire for self-reported functional health assessment.
- Compared 239 post-surgical patients (aged 10-20) with 288 healthy controls.
- Employed multivariate analysis to explore associations between clinical factors (e.g., Risk Adjusted Classification for Congenital Heart Surgery, Aristotle Basic Complexity Score) and functional health domains.
Main Results:
- No significant differences in most functional health domains were observed between operated children and controls.
- Male gender positively correlated with physical, mental, and general health.
- Higher parental education was linked to better scores in family activities, physical, emotional, and general health.
- Living with a single parent negatively impacted mental health.
- Higher Risk Adjusted Classification for Congenital Heart Surgery (Category 4) was associated with poorer behavioral outcomes.
Conclusions:
- Overall functional health in children post-congenital heart surgery is comparable to their peers.
- Key factors influencing functional health include child's gender, parental education, family structure, and surgical risk stratification.
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.
