Wray Jo, Ryde Matthew, Butler Colin R, Hewitt Richard J
Heart and Lung Directorate, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Interact Cardiovasc Thorac Surg. 2019 Dec 1;29(6):876-882. doi: 10.1093/icvts/ivz194.
The objectives of this study were to measure 'health-related quality of life' (HRQoL) in children following slide tracheoplasty for long-segment tracheal stenosis (LSTS) and to explore the relationship of comorbidities and parental mental health with HRQoL outcomes.
A cross-sectional study was undertaken with children who had undergone slide tracheoplasty. Participants included parents and children (age 5-15 years) recruited over a 13-month period, who were asked to complete validated measures of HRQoL, development and behaviour. Scores were compared to published norms.
Forty-two children (male 69%; n = 29) were included; mean age was 5.3 (standard deviation 3.5) years and mean follow-up was 45 (range 4-179) months. Mean total HRQoL scores for children with repaired LSTS did not differ from those of healthy norms other than for children aged 13-23 months, but 10 children (24%) had scores >2 SD below the mean for healthy children. HRQoL was poorer in children with non-cardiac congenital comorbidities than in those with isolated LSTS (mean scores 60.34 ± 17.19 and 85.52 ± 12.19, respectively, P = 0.01). There was good agreement between children's and parents' scores, although children rated their HRQoL as better than their parents did. Anxious parents rated their children's HRQoL as significantly worse than non-anxious parents (P<0.001).
Older children with isolated LSTS can have excellent HRQoL after surgery. Younger children, at an earlier time point postoperatively, and those with non-cardiac congenital comorbidities have poorer HRQoL. Further longitudinal evaluation is required to identify psycho-social (including parental) predictors of outcome which may inform, or be amenable to, intervention.
本研究的目的是测量长段气管狭窄(LSTS)患儿行滑动气管成形术后的“健康相关生活质量”(HRQoL),并探讨合并症及父母心理健康与HRQoL结果之间的关系。
对接受滑动气管成形术的患儿进行横断面研究。参与者包括在13个月期间招募的父母和儿童(年龄5 - 15岁),他们被要求完成经过验证的HRQoL、发育和行为测量。将得分与已发表的标准进行比较。
纳入42名儿童(男性占69%;n = 29);平均年龄为5.3(标准差3.5)岁,平均随访时间为45(范围4 - 179)个月。除13 - 23个月龄的儿童外,LSTS修复患儿的平均HRQoL总分与健康标准无差异,但10名儿童(24%)的得分比健康儿童的平均分低2个标准差以上。合并非心脏先天性疾病的儿童的HRQoL比单纯LSTS患儿差(平均得分分别为60.34 ± 17.19和85.52 ± 12.19,P = 0.01)。儿童和父母的得分之间有很好的一致性,尽管儿童对自己HRQoL的评分高于父母。焦虑的父母对其孩子HRQoL的评分明显低于非焦虑的父母(P<0.001)。
单纯LSTS的大龄儿童术后可具有良好的HRQoL。年龄较小的儿童、术后早期以及合并非心脏先天性疾病的儿童的HRQoL较差。需要进一步进行纵向评估,以确定可能为干预提供信息或适合干预的心理社会(包括父母)预后预测因素。