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Health-related quality of life after open-heart surgery
Helene Werner1, Beatrice Latal2, Emanuela Valsangiacomo Buechel3
1Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland.
Insights
Health-related quality of life (HRQoL) is reduced in infants with congenital heart disease (CHD), particularly in physical and cognitive areas by age 4. Early HRQoL, genetic defects, and tube feeding predict later outcomes.
Area of Science:
- Pediatrics
- Cardiology
- Quality of Life Research
Background:
- Congenital heart disease (CHD) affects a significant number of infants.
- Understanding the long-term health-related quality of life (HRQoL) in these children is crucial for effective management.
- Previous research has highlighted various challenges faced by children with CHD, but longitudinal HRQoL data is still developing.
Purpose of the Study:
- To assess the health-related quality of life (HRQoL) in infants with congenital heart disease (CHD) at 1 year of age.
- To track changes in HRQoL in these children by age 4 years.
- To identify predictors of HRQoL in young children with CHD.
Main Methods:
- A prospective cohort study involving 144 infants who underwent cardiopulmonary bypass surgery for CHD before 6 months of age.
- Parent-completed questionnaires assessed child HRQoL at 1 and 4 years.
- Medical data were retrospectively collected from hospital records.
Main Results:
- At 1 year, infants with CHD showed significantly reduced physical functioning compared to healthy controls.
- By age 4 years, children with CHD exhibited poorer cognitive functioning but improved social functioning relative to controls.
- Lower HRQoL at age 4 was predicted by an underlying genetic defect, tube feeding at 1 year, and lower HRQoL at 1 year, but not by CHD type (univentricular vs. biventricular).
Conclusions:
- Infants and preschool-aged children with CHD experience impaired physical and cognitive HRQoL.
- Children with lower initial HRQoL, genetic defects, or requiring tube feeding warrant close monitoring for timely interventions.
- These findings underscore the importance of a holistic approach to managing CHD, considering developmental and functional outcomes.
Objectives:
To determine health-related quality of life (HRQoL) in 1-year-old infants with congenital heart disease (CHD), to follow-up with these children at age 4 years, and to examine predictors of HRQoL.
Study Design:
Parents of 144 infants who had undergone cardiopulmonary bypass surgery for CHD before age 6 months were prospectively included in this cohort study. Parents completed a standardized questionnaire on child HRQoL at 1 year and 4 years of age; medical data were extracted from the patients' hospital records.
Results:
Parents reported a significant reduction of the children's physical functioning compared with healthy controls at age 1 year. At age 4 years, children with CHD had poorer cognitive functioning but better social functioning compared with healthy controls. Lower HRQoL at age 4 years was not significantly predicted by univentricular or biventricular CHD but was predicted by the presence of an underlying genetic defect, tube feeding at 1 year, and lower HRQoL at 1 year.
Conclusion:
This study shows that HRQoL of infants and preschool-age children with CHD is impaired in physical and cognitive dimensions. Children with lower overall HRQoL at age 1 year, an underlying genetic defect, and tube feeding need to be monitored carefully to provide appropriate and timely interventions.
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