The Journal of Pediatrics
Volume 152, Issue 3 , Pages 349-355, March 2008

Health-Related Quality of Life in Children and Adolescents after Open-Heart Surgery

  • Markus A. Landolt, PhD

      Affiliations

    • Department of Psychosomatics and Psychiatry, University Children’s Hospital, Zurich, Switzerland
    • ,
  • Emanuela R. Valsangiacomo Buechel, MD

      Affiliations

    • Department of Pediatric Cardiology, University Children’s Hospital, Zurich, Switzerland
    • ,
  • Bea Latal, MD, MPH

      Affiliations

    • Child Development Center, University Children’s Hospital, Zurich, Switzerland.

Received 22 December 2006; received in revised form 11 June 2007; accepted 5 July 2007. published online 10 October 2007.

Objective

To assess health-related quality of life (HRQOL) in children with congenital heart disease (CHD) after open-heart surgery and to identify medical, individual, and family-related predictors of outcome.

Study design

Cross-sectional cohort study. 155 children with CHD (40% cyanotic type) who underwent open-heart surgery between 1995 and 1998 were eligible. One hundred and ten patients (response rate 71%) were investigated at a mean age of 10.4 years. Mean age at operation was 2.3 years (range, 0-8.7 years), mean duration of cardiopulmonary bypass was 95 minutes (range, 5-206 minutes), and circulatory arrest was performed in 9% of the children. Child- and parent-rated HRQOL was evaluated by the TNO-AZL Child Quality of Life Questionnaire. Scores were compared with healthy references.

Results

Most dimensions of self-reported HRQOL were impaired, including autonomy and motor, social, and emotional functioning. In addition to the children’s ratings, parents rated cognitive functioning of their children as diminished. Multivariate analyses revealed that duration of cardiopulmonary bypass, length of hospitalization, need for current cardiac medication, and adverse family relationships had a negative impact on parent- but not on child-rated HRQOL.

Conclusions

HRQOL is impaired in children with CHD after open-heart surgery. Medical variables and the quality of family relationships are important determinants.

Abbreviations: CHD, Congenital heart disease, FRI, Family Relationship Index, HRQOL, Health-related quality of life, SES, Socioeconomic status, TACQOL, TNO-AZL Child Quality of Life Questionnaire, TGA, Transposition of the great arteries

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 Supported by Foundation Mercator. The sponsor had no influence on study design, the collection, analysis, and interpretation of data, the writing of the report, and the decision to submit the paper for publication.

 Reprint requests: No reprints available from authors.

PII: S0022-3476(07)00662-2

doi:10.1016/j.jpeds.2007.07.010

The Journal of Pediatrics
Volume 152, Issue 3 , Pages 349-355, March 2008

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