Neil Derridj1, Damien Bonnet2, Johanna Calderon3, Pascal Amedro4, Nathalie Bertille5, Nathalie Lelong5, Francois Goffinet5, Babak Khoshnood5, Romain Guedj6. 1. Center of Research in Epidemiology and Statistics, Inserm, INRA, University of Paris, Paris, France; M3C-Pediatric Cardiology, Necker Enfants Malades, AP-HP, University of Paris, Paris, France. Electronic address: neil.derridj@inserm.fr. 2. M3C-Pediatric Cardiology, Necker Enfants Malades, AP-HP, University of Paris, Paris, France. 3. Physiology and Experimental Medicine Heart Muscles, UMR CNRS 9214, Inserm U1046, University of Montpellier, Montpellier, France; Department of Psychiatry, Harvard Medical School, Boston Children's Hospital, Boston, MA. 4. Paediatric and Congenital Cardiology Department, M3C National Reference Centre, Bordeaux University Hospital, IHU Liryc, Electrophysiology and Heart Modelling Institute, Bordeaux University Foundation, Pessac, France. 5. Center of Research in Epidemiology and Statistics, Inserm, INRA, University of Paris, Paris, France. 6. Center of Research in Epidemiology and Statistics, Inserm, INRA, University of Paris, Paris, France; Pediatric Emergency Department, Faculty of Medicine, AP-HP, Armand Trousseau Hospital, Sorbonne University, Paris, France.
Abstract
OBJECTIVES: To identify subgroups with a congenital heart defect (CHD) at risk of health-related quality of life (QoL) impairment at 8 years of age according to their medical and surgical management. STUDY DESIGN: From a prospective population-based cohort study, 598 patients with CHD were subdivided according to their medical and surgical management: (1) CHD followed-up in an outpatient clinic, (2) complete repair before age 3 years, (3) complete repair after age 3 years, (4) palliative repair, or (5) CHD with spontaneous resolution (reference subgroup). Self-reported QoL and parent-reported QoL were measured using the Pediatric Quality of Life Inventory version 4.0 (score range, 0-100) at age 8 years. Multivariable regression analysis and Cohen effect size were used to compare outcomes across the CHD groups. RESULTS: Self-reported and parent-reported QoL scores for the palliative repair subgroup were lower (β = -2.1 [95% CI, -3.9 to -0.2] and β = -16.0 [95% CI, -22.4 to -9.5], respectively), with a large effect size (δ = -0.9 [95% CI, -1.4 to -0.4] and δ = -1.3 [95% CI, -1.8 to -0.7], respectively). Parent-reported QoL scores for the complete repair after age 3 years subgroup were lower (β = -9.2; 95% CI, -15.0 to -3.5), with a large effect size (δ = -0.9; 95% CI, -1.4 to -0.5). Self-reported QoL scores for the complete repair before age 3 years subgroup was lower (β = -1.3; 95% CI, -1.9 to -0.6), with a small effect size (δ = -0.4; 95% CI, -0.6 to -0.2). CONCLUSIONS: The QoL of children with CHD who experienced a hospital intervention is reduced at age 8 years. Patient age at the last cardiac intervention might influence QoL at 8 years.
OBJECTIVES: To identify subgroups with a congenital heart defect (CHD) at risk of health-related quality of life (QoL) impairment at 8 years of age according to their medical and surgical management. STUDY DESIGN: From a prospective population-based cohort study, 598 patients with CHD were subdivided according to their medical and surgical management: (1) CHD followed-up in an outpatient clinic, (2) complete repair before age 3 years, (3) complete repair after age 3 years, (4) palliative repair, or (5) CHD with spontaneous resolution (reference subgroup). Self-reported QoL and parent-reported QoL were measured using the Pediatric Quality of Life Inventory version 4.0 (score range, 0-100) at age 8 years. Multivariable regression analysis and Cohen effect size were used to compare outcomes across the CHD groups. RESULTS: Self-reported and parent-reported QoL scores for the palliative repair subgroup were lower (β = -2.1 [95% CI, -3.9 to -0.2] and β = -16.0 [95% CI, -22.4 to -9.5], respectively), with a large effect size (δ = -0.9 [95% CI, -1.4 to -0.4] and δ = -1.3 [95% CI, -1.8 to -0.7], respectively). Parent-reported QoL scores for the complete repair after age 3 years subgroup were lower (β = -9.2; 95% CI, -15.0 to -3.5), with a large effect size (δ = -0.9; 95% CI, -1.4 to -0.5). Self-reported QoL scores for the complete repair before age 3 years subgroup was lower (β = -1.3; 95% CI, -1.9 to -0.6), with a small effect size (δ = -0.4; 95% CI, -0.6 to -0.2). CONCLUSIONS: The QoL of children with CHD who experienced a hospital intervention is reduced at age 8 years. Patient age at the last cardiac intervention might influence QoL at 8 years.