Self-reported functional health status following interrupted aortic arch repair: A Congenital Heart Surgeons' Society Study.
J Thorac Cardiovasc Surg
; 157(4): 1577-1587.e10, 2019 04.
Article
em En
| MEDLINE
| ID: mdl-30770109
ABSTRACT
OBJECTIVES:
Improved survival after congenital heart surgery has led to interest in functional health status. We sought to identify factors associated with self-reported functional health status in adolescents and young adults with repaired interrupted aortic arch.METHODS:
Follow-up of survivors (aged 13-24 years) from a 1987 to 1997 inception cohort of neonates included completion of functional health status questionnaires (Child Health Questionnaire-CF87 [age <18 years, n = 51] or the Short Form [SF]-36 [age ≥18 years, n = 66]) and another about 22q11 deletion syndrome (22q11DS) features (n = 141). Factors associated with functional health status domains were determined using multivariable linear regression analysis.RESULTS:
Domain scores of respondents were significantly greater than norms in 2 of 9 Child Health Questionnaire-CF87 and 4 of 10 SF-36 domains and only lower in the physical functioning domain of the SF-36. Factors most commonly associated with lower scores included those suggestive of 22q11DS (low calcium levels, recurrent childhood infections, genetic testing/diagnosis, abnormal facial features, hearing deficits), the presence of self-reported behavioral and mental health problems, and a greater number of procedures. Factors explained between 10% and 70% of domain score variability (R2 = 0.10-0.70, adj-R2 = 0.09-0.66). Of note, morphology and repair type had a minor contribution.CONCLUSIONS:
Morbidities associated with 22q11DS, psychosocial issues, and recurrent medical issues affect functional health status more than initial morphology and repair in this population. Nonetheless, these patients largely perceive themselves as better than their peers. This demonstrates the chronic nature of interrupted aortic arch and suggests the need for strategies to decrease reinterventions and for evaluation of mental health and genetic issues to manage associated deteriorations.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
2_ODS3
/
6_ODS3_enfermedades_notrasmisibles
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de saúde:
2_muertes_prevenibles
/
6_cardiovascular_diseases
/
6_congenital_chromosomal_anomalies
/
6_endocrine_disorders
/
6_other_circulatory_diseases
/
7_environmental_health
/
7_neonatal_care_health
/
7_non_communicable_diseases
Assunto principal:
Aorta Torácica
/
Nível de Saúde
/
Saúde Mental
/
Sobreviventes
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Síndrome de DiGeorge
/
Autorrelato
/
Cardiopatias Congênitas
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
/
Patient_preference
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Thorac Cardiovasc Surg
Ano de publicação:
2019
Tipo de documento:
Article