Seattle Children's Hospital, Seattle, WA.
Institute for Disease Modeling, Bellevue, WA.
J Pediatr. 2020 Jan;216:13-18.e1. doi: 10.1016/j.jpeds.2019.08.049. Epub 2019 Oct 4.
To evaluate disease-specific and age-related factors contributing to health-related quality of life (HRQOL). in children with intestinal failure.
A prospective study of HRQOL was performed in a regional intestinal rehabilitation program. Parent-proxy Pediatric Quality of Life Inventory surveys were administered annually to families of 91 children with intestinal failure over a 6-year period. Survey data was stratified by age and compared with pediatric HRQOL data in healthy and chronically ill populations. Linear mixed-effect models using multivariable regression were constructed to identify associations with HRQOL.
A total of 180 surveys were completed by 91 children and their families. HRQOL scores were lowest for children ages 5-7 years (P < .001) and 8-12 years (P < .01), and these changes were primarily related to school dimension scores. In multivariable regression, age of 5 years and older and developmental delay were independently associated with lower HRQOL scores. The trend toward lower HRQOL scores parallels reference data from healthy and chronically ill children, although patients with intestinal failure scored lower than both populations at school age.
Children with intestinal failure experience lower parent-proxy HRQOL scores in the 5-7 and 8-12 year age groups primarily related to school dimension scores. Multicenter data to validate these findings and identify interventions to improve QOL for children with intestinal failure are needed.
评估与疾病特异性和年龄相关的因素对患有肠衰竭儿童的健康相关生活质量(HRQOL)的影响。
在区域性肠康复计划中进行了 HRQOL 的前瞻性研究。在 6 年的时间里,对 91 名患有肠衰竭的儿童的家庭进行了年度父母代理儿科生活质量量表调查。根据年龄对调查数据进行分层,并与健康和慢性疾病人群的儿科 HRQOL 数据进行比较。使用多变量回归的线性混合效应模型来确定与 HRQOL 的关联。
共完成了 180 份调查,涉及 91 名儿童及其家庭。5-7 岁(P<0.001)和 8-12 岁(P<0.01)儿童的 HRQOL 评分最低,这些变化主要与学校维度评分有关。在多变量回归中,5 岁及以上年龄和发育迟缓与较低的 HRQOL 评分独立相关。HRQOL 评分下降的趋势与健康和慢性疾病儿童的参考数据相似,尽管在学龄期,肠衰竭患者的评分低于这两个群体。
患有肠衰竭的儿童在 5-7 岁和 8-12 岁年龄组的父母代理 HRQOL 评分较低,主要与学校维度评分有关。需要多中心数据来验证这些发现,并确定改善肠衰竭儿童生活质量的干预措施。