Division of Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Division of Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
J Pediatr. 2014 Apr;164(4):781-788.e1. doi: 10.1016/j.jpeds.2013.11.066. Epub 2014 Jan 10.
To compare health-related quality of life (HRQOL) in a group of pediatric patients with congenital heart disease (CHD) and healthy controls and patients with other chronic diseases, and to compare HRQOL among patients with CHD of various severity categories with one another, with controls, and with patients with other chronic diseases.
In this cross-sectional survey, t tests were used to compare patient and proxy-reported Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL) scores (including total, physical health, and psychosocial health summary scores) in children (aged 8-12 years) and adolescents (aged 13-18 years) between controls and (1) a composite CHD population; and (2) patients in each of 3 CHD severity categories: mild (no intervention), biventricle (BV; postintervention), and single ventricle (SV; postpalliation). PedsQL scores among CHD severity categories were compared by ANOVA. PedsQL scores were also compared in the CHD population and children with other chronic diseases without age stratification using t tests.
There were 1138 (children, n = 625; adolescents, n = 513) and 771 (children, n = 528; adolescents, n = 243) patient and/or proxy reporters in the CHD and healthy control groups, respectively. Total, physical health, and psychosocial health summary scores were lower in the composite CHD, BV, and SV groups compared with controls (P < .0001). There were significant differences among disease severity categories for all scores (P < .01). The composite CHD, BV, and SV groups had similar PedsQL scores as end-stage renal disease, asthma, and obesity populations.
Children and adolescents with BV and SV CHD have significantly lower HRQOL than healthy controls and similar HRQOL as patients with other chronic pediatric diseases. Interventions targeting both physical and psychosocial domains are needed to improve HRQOL in this high-risk population.
比较一组先天性心脏病 (CHD) 儿科患者与健康对照者和其他慢性病患者的健康相关生活质量 (HRQOL),并比较不同严重程度 CHD 患者之间、与对照者之间以及与其他慢性病患者之间的 HRQOL。
在这项横断面调查中,使用 t 检验比较了儿童(8-12 岁)和青少年(13-18 岁)的患者和代理人报告的儿童生活质量量表 4.0 通用核心量表(PedsQL)评分(包括总分、生理健康和心理社会健康总分),这些评分来自对照组和(1)综合 CHD 人群;和(2)3 种 CHD 严重程度类别中的每一种患者:轻症(无需干预)、双心室(干预后)和单心室(姑息治疗后)。通过方差分析比较 CHD 严重程度类别的 PedsQL 评分。通过 t 检验还比较了 CHD 人群与无年龄分层的其他慢性病儿童的 PedsQL 评分。
CHD 组和健康对照组分别有 1138 名(儿童,n=625;青少年,n=513)和 771 名(儿童,n=528;青少年,n=243)患者和/或代理报告者。与对照组相比,综合 CHD、BV 和 SV 组的总分、生理健康和心理社会健康总分较低(P<0.0001)。所有评分在疾病严重程度类别之间均有显著差异(P<.01)。复合 CHD、BV 和 SV 组与终末期肾病、哮喘和肥胖症患者的 PedsQL 评分相似。
BV 和 SV CHD 的儿童和青少年的 HRQOL 明显低于健康对照者,与其他慢性儿科疾病患者的 HRQOL 相似。需要针对生理和心理社会领域的干预措施来提高这一高危人群的 HRQOL。