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小儿肺移植后的生活质量结果

Quality of life outcomes following pediatric lung transplantation.

作者信息

Lazor Tanya, Grasemann Hartmut, Solomon Melinda, Anthony Samantha J

机构信息

Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Canada.

Department of Social Work, The Hospital for Sick Children, Toronto, Canada.

出版信息

Pediatr Pulmonol. 2017 Nov;52(11):1495-1501. doi: 10.1002/ppul.23788. Epub 2017 Sep 14.

Abstract

PURPOSE

Compared to other solid organs, survival after lung transplantation (LTx) is still poor. Discussions on survival benefits following LTx in children, however, have largely concentrated on medical outcome data. Little research describes quality of life (QoL) of pediatric LTx recipients, which is partly due to the small number of pediatric LTxs performed. Only two centers worldwide performed >10 pediatric LTxs in 2013, making data on QoL in this population difficult to obtain. The primary objective was to examine the impact of LTx on QoL of pediatric recipients.

METHODS

LTx recipients aged 8-17 years and their parents were recruited from a Canadian pediatric transplant centre. Participants completed the PedsQL 4.0 Generic Core Scales, a validated health-related QoL patient-reported outcome measure for children and adolescents, pre-transplant and two times post-transplant. Pre-LTx QoL scores were compared with initial assessment scores post-LTx and changes in QoL over time were described. Correlations between self- and proxy-reports were also discussed.

RESULTS

Ten pediatric LTx recipients (six male, mean age = 13.3 years) and their parents were enrolled. Assessments were completed pre-LTx (mean months = 4.8) and two times post-LTx (mean months 8.7 and 24.6, respectively). Pre- and post-transplant total scores differed significantly for both self- and proxy-report, which remained consistent at a second assessment post-transplant (P = 0.018 and 0.028, respectively).

CONCLUSIONS

Findings highlight the importance of QoL outcomes when exploring LTx as a treatment option. Future research should explore long-term QoL outcomes post-LTx and examine standardized integration of patient-reported outcomes into clinical practice.

摘要

目的

与其他实体器官相比,肺移植(LTx)后的生存率仍然很低。然而,关于儿童LTx后的生存益处的讨论主要集中在医学结果数据上。很少有研究描述儿童LTx受者的生活质量(QoL),部分原因是儿童LTx的例数较少。2013年全球仅有两个中心进行了超过10例儿童LTx,使得该人群的QoL数据难以获得。主要目的是研究LTx对儿童受者QoL的影响。

方法

从加拿大一家儿科移植中心招募了8至17岁的LTx受者及其父母。参与者在移植前以及移植后两次完成了儿童生活质量量表4.0通用核心量表,这是一种经过验证的、用于儿童和青少年的与健康相关的生活质量患者报告结局测量工具。将LTx前的QoL评分与LTx后的初始评估评分进行比较,并描述QoL随时间的变化。还讨论了自我报告与代理报告之间的相关性。

结果

招募了10名儿童LTx受者(6名男性,平均年龄 = 13.3岁)及其父母。在LTx前(平均月数 = 4.8)以及LTx后两次(分别为平均月数8.7和24.6)完成了评估。自我报告和代理报告的移植前和移植后总分均有显著差异,在移植后的第二次评估中保持一致(分别为P = 0.018和0.028)。

结论

研究结果突出了在探索将LTx作为一种治疗选择时QoL结局的重要性。未来的研究应探索LTx后的长期QoL结局,并研究将患者报告结局标准化整合到临床实践中的情况。

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