在学龄前心脏手术幸存者的行为问题
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
概括
复杂心脏手术后儿童的行为问题与非心脏病住院有关. 解决这些住院治疗可能会改善这些幸存者的行为结果.
科学领域:
- 儿童心脏病学 儿童心脏病学
- 发展心理学 发展心理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在复杂心脏手术 (CCSx) 的幸存者中,人们注意到行为问题 (BC),但影响这些结果的因素尚未确立.
- 关于影响CCSx幸存者的BC的健康和人口变量的证据不一致.
- 了解BC的预测因素对于在这个脆弱人群中进行有针对性的干预至关重要.
研究的目的:
- 为了确定人口统计学,急性护理和健康因素,预测复杂的心脏手术后婴儿的行为问题.
- 评估各种临床和社会变量与学龄前儿童行为结果之间的关联.
- 为改善儿童心脏手术幸存者的长期神经发育结果的策略提供信息.
主要方法:
- 一项前性初始队列研究包括585名没有染色体异常的婴儿,他们在2001年至2017年期间接受了CCSx.
- 行为结果在4.5岁时使用儿童行为评估系统 (BASC-II/III) 的家长评级表进行评估.
- 多重后勤回归确定了外部化,内部化行为,适应性功能和整体行为症状的独立预测因素.
主要成果:
- 非心脏病住院患者独立预测外化行为 (OR: 1.10),内化行为 (OR: 1.14) 和整体行为症状 (OR: 1.10) 的几率增加.
- 女性性别和单心室生理学与更高的内化行为概率有关.
- 较低的社会经济地位和较少的母亲学龄预测了较差的适应性行为,而体外生命支持预测了更普遍的行为症状.
结论:
- 非心脏病住院人数是复杂心脏手术后儿童行为问题增加的重要预测指标.
- 旨在减少非心脏病住院的干预措施,例如改善创伤信息化护理和初级保健准入,可能会减轻行为问题.
- 需要进一步的研究和临床关注,以解决影响该人口行为结果的可修改因素.
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