Clement Karsenty1, Philippe Maury2, Nathalie Blot-Souletie3, Magalie Ladouceur4, Bertrand Leobon5, Valérie Senac3, Pierre Mondoly3, Meyer Elbaz3, Michel Galinier3, Yves Dulac6, Didier Carrié3, Philippe Acar6, Sebastien Hascoet7. 1. Paediatric Cardiology Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France; Department of Cardiology, Toulouse University Hospital, Toulouse, France; Inserm U1048, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Toulouse, France. Electronic address: clement.karsenty@hotmail.fr. 2. Department of Cardiology, Toulouse University Hospital, Toulouse, France; Inserm U1048, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Toulouse, France. 3. Department of Cardiology, Toulouse University Hospital, Toulouse, France. 4. Adult Congenital Heart Disease Unit, Hôpital Européen Georges-Pompidou-Necker, AP-HP, Inserm U970-PARCC, Paris Descartes University, Paris, France. 5. Department of Congenital Heart Disease Surgery, Children's Hospital, Toulouse University Hospital, Toulouse, France. 6. Paediatric Cardiology Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France. 7. Paediatric Cardiology Unit, Children's Hospital, Toulouse University Hospital, Toulouse, France; Department of Cardiology, Toulouse University Hospital, Toulouse, France; Inserm U1048, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Toulouse, France.
Abstract
BACKGROUND: In recent decades, advances in surgery and therapeutic catheterization have steadily increased the life expectancy and prevalence of adults with congenital heart disease (CHD). AIMS: We assessed medical and psychosocial variables of adults with CHD, according to the disease complexity. METHODS: We included, from a single-centre observational cohort study, 135 consecutive adults with CHD (median age of 40 years, interquartile range: 28.0-51.0) followed in our cardiology unit, who answered a questionnaire assessing daily activity and psychosocial functioning. Disease complexity was classified according to the Bethesda conference. RESULTS: Cardiac malformation complexity was simple in 61 (45.2%), moderate in 50 (37.0%) and complex in 24 (17.8%) patients. Cardiac surgery had been performed in 86.5% of moderate and complex patients. Complications (such as heart failure, arrhythmia and pulmonary hypertension) were mainly observed in the complex group (P=0.003). Physical activity was lower in the complex group (no activity in 58.8%, but sport previously contraindicated in 50% of these; P=0.03). Education level tended to be lower in the complex and moderate groups than in the simple group (respectively, 31.2% and 33.3% vs. 45.7% had passed the Baccalaureate; P=0.47). The pass rate was lower in patients with complications (P=0.037) or more than one cardiac surgery (P=0.03). In the complex group, 56.3% of patients were unemployed (P=0.048). CONCLUSIONS: Complexity of heart disease and medical history affect education level and employment of adults with CHD. Academic education of children with a complex defect and career counselling are important to prevent unemployment among adults with CHD.
BACKGROUND: In recent decades, advances in surgery and therapeutic catheterization have steadily increased the life expectancy and prevalence of adults with congenital heart disease (CHD). AIMS: We assessed medical and psychosocial variables of adults with CHD, according to the disease complexity. METHODS: We included, from a single-centre observational cohort study, 135 consecutive adults with CHD (median age of 40 years, interquartile range: 28.0-51.0) followed in our cardiology unit, who answered a questionnaire assessing daily activity and psychosocial functioning. Disease complexity was classified according to the Bethesda conference. RESULTS: Cardiac malformation complexity was simple in 61 (45.2%), moderate in 50 (37.0%) and complex in 24 (17.8%) patients. Cardiac surgery had been performed in 86.5% of moderate and complex patients. Complications (such as heart failure, arrhythmia and pulmonary hypertension) were mainly observed in the complex group (P=0.003). Physical activity was lower in the complex group (no activity in 58.8%, but sport previously contraindicated in 50% of these; P=0.03). Education level tended to be lower in the complex and moderate groups than in the simple group (respectively, 31.2% and 33.3% vs. 45.7% had passed the Baccalaureate; P=0.47). The pass rate was lower in patients with complications (P=0.037) or more than one cardiac surgery (P=0.03). In the complex group, 56.3% of patients were unemployed (P=0.048). CONCLUSIONS: Complexity of heart disease and medical history affect education level and employment of adults with CHD. Academic education of children with a complex defect and career counselling are important to prevent unemployment among adults with CHD.
Authors: Pascal Amedro; Oscar Werner; Hamouda Abassi; Aymeric Boisson; Luc Souilla; Sophie Guillaumont; Johanna Calderon; Anne Requirand; Marie Vincenti; Victor Pommier; Stefan Matecki; Gregoire De La Villeon; Kathleen Lavastre; Alain Lacampagne; Marie-Christine Picot; Constance Beyler; Christophe Delclaux; Yves Dulac; Aitor Guitarte; Philippe Charron; Isabelle Denjoy-Urbain; Vincent Probst; Alban-Elouen Baruteau; Philippe Chevalier; Sylvie Di Filippo; Jean-Benoit Thambo; Damien Bonnet; Jean-Luc Pasquie Journal: Health Qual Life Outcomes Date: 2021-07-28 Impact factor: 3.186