RESUMO
Objective: Neurodevelopmental impairment has been realized as the most common complication in children with congenital heart disease undergoing cardiac surgery during the past 30 years. But little attention has been paid to this problem in China. The potential risk factors for adverse outcomes include demographic, perioperative, and socioeconomic factors, which are vastly different in China compared with the developed countries in previous reports. Methods: Four hundred twenty-six patients (aged 35.9 ± 18.6 months) at about 1- to 3-year follow-up after cardiac surgery were prospectively enrolled from March 2019 to February 2022. Griffiths Mental Development Scales-Chinese was used to evaluate the quotients of overall development and 5 subscales of the child's locomotor, language, personal-social, eye-hand coordination, and performance skills. Demographic, perioperative, socioeconomic, and feeding type during the first year of life (breastfeeding, mixed, or never breastfeeding) were examined to identify the risk factors for adverse neurodevelopmental outcomes. Results: Mean scores were 90.0 ± 15.5 for development quotient, 92.3 ± 19.4 for locomotor, 89.6 ± 19.2 for personal-social, 85.5 ± 21.7 for language, 90.3 ± 17.2 for eye-hand coordination, and 92 ± 17.1 for performance subscales. For the entire cohort, the impairment in at least 1 subscale was found in 76.1% of the cohort (>1 SD below population mean) with 50.1% being severe (>2 SDs below the mean). The significant risk factors included prolonged hospital stay, peak level of postoperative C-reactive protein, socioeconomic status, and never breastfeeding or mixed feeding. Conclusions: Neurodevelopmental impairment is substantial in terms of incidence and severity in children with congenital heart disease undergoing cardiac surgery in China. Risk factors contributing to the adverse outcomes included prolonged hospital stay, early postoperative inflammatory response, socioeconomic status, and never breastfeeding or mixed feeding. There is an urgent need for standardized follow-up and neurodevelopmental assessment in this special group of children in China.
RESUMO
The present study aimed to develop a Chinese equivalence version of the Letter-Number (LN) Span Test and to explore the preliminary construct and discriminative validity of the developed version among a group of healthy Chinese volunteers and patients with stroke. A group of 165 (73 men and 92 women) healthy participants were recruited for the validation study, most of them were undergraduates or postgraduates. Moreover, a comparison was made between nine patients with stroke and the healthy controls. For the healthy sample, the Chinese version correlated significantly with the English version in total number of correct span (r = .6, p < .00001) and the longest span (r = .5, p < .00005). The Chinese version of LN Span Test was also found to be significantly associated with memory-loaded tests but not other tests. A series of ANCOVAs controlling for age, education, and IQ indicated that stroke patients performed significantly worse than the healthy controls in LN Span total number of correct responses (p < .04), immediate recall (p < .0005), and delayed recall (p < .0005) of WMS-R, SART total number of correct response (p < .0005), PASAT dyads correct response (p < .01). The preliminary findings suggest that the Chinese version of the LN Span Test shows impressive preliminary validity among a group of healthy volunteers and an impressive clinical discriminative validity among a group of stroke cases.