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Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
Published on: May 26, 2023
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Behaviour Concerns in Preschool Cardiac Surgery Survivors
Sabrina H Y Eliason1,2, Charlene M T Robertson1,2, Susan A Bobbitt3
1Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
CJC Pediatric and Congenital Heart Disease
|November 4, 2024
Summary
Behaviour concerns in children after complex cardiac surgery are linked to noncardiac hospitalizations. Addressing these hospitalizations may improve behavioral outcomes for these survivors.
Area of Science:
- Pediatric Cardiology
- Developmental Psychology
- Health Services Research
Background:
- Behaviour concerns (BC) are noted in survivors of complex cardiac surgery (CCSx), but factors influencing these outcomes are not well-established.
- Evidence regarding health and demographic variables impacting BC in CCSx survivors is inconsistent.
- Understanding predictors of BC is crucial for targeted interventions in this vulnerable population.
Purpose of the Study:
- To identify demographic, acute care, and health factors predicting behavior concerns in infants following complex cardiac surgery.
- To evaluate the association between various clinical and social variables and behavioral outcomes at preschool age.
- To inform strategies for improving long-term neurodevelopmental outcomes in pediatric cardiac surgery survivors.
Main Methods:
- A prospective inception-cohort study included 585 infants without chromosomal abnormalities undergoing CCSx between 2001 and 2017.
- Behavioral outcomes were assessed at 4.5 years using parent rating scales from the Behaviour Assessment System for Children (BASC-II/III).
- Multiple logistic regression identified independent predictors of externalizing, internalizing behaviors, adaptive functioning, and overall behavioral symptoms.
Main Results:
- Noncardiac hospitalizations independently predicted increased odds of externalizing behaviors (OR: 1.10), internalizing behaviors (OR: 1.14), and overall behavioral symptoms (OR: 1.10).
- Female sex and single ventricle physiology were associated with higher odds of internalizing behaviors.
- Lower socioeconomic status and fewer years of maternal schooling predicted poorer adaptive behavior, while extracorporeal life support predicted more pervasive behavioral symptoms.
Conclusions:
- The number of noncardiac hospitalizations is a significant predictor of increased behavior concerns in children after complex cardiac surgery.
- Interventions aimed at reducing noncardiac hospitalizations, such as improving trauma-informed care and primary care access, may mitigate behavioral issues.
- Further research and clinical attention are warranted to address modifiable factors impacting behavioral outcomes in this population.
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