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新生儿大动脉调转术后的年轻成年人自我感知生活质量与社会人口学参数和非心脏合并症的关系。

Socio-demographic parameters and non-cardiac comorbidity related to self-perceived quality of life in young adults after neonatal arterial switch operation for transposition of the great arteries.

机构信息

Department of Pediatric Cardiology, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.

Superregional Center for Adults with Congenital Heart Disease, University Hospital RWTH Aachen, Aachen, Germany.

出版信息

Heart Vessels. 2023 Apr;38(4):570-580. doi: 10.1007/s00380-022-02188-8. Epub 2022 Oct 28.

Abstract

Evaluating the relation of non-cardiac comorbidity and socio-demographic factors to physical and mental health-related quality of life (QOL) which has been partially found at elevated risk in young adults after neonatal arterial switch operation (ASO) for transposition of the great arteries (TGA). In a prospective reassessment study, results of 92 unselected young adults (22.8 ± 2.6 years) having undergone evaluation of QOL (SF-36) were related to non-cardiac comorbidity with special respect to neurologic and psychiatric comorbidity and to socio-demographic parameters. Neurologic (14%) contrary to psychiatric comorbidities (6.5%) were more frequent than in the general population. The educational level was higher, the rate of unemployment was double as high compared to the average German population. Significant inverse relations (p = 0.006 to 0.033) existed between physical health domains (physical functioning and general health perception) and non-cardiac, neurologic, and psychiatric comorbidity, as well as correlations between the latter domains and socio-economic status, educational level, and worse employment status (Spearman 0.22-0.41, p < 0.0001 to 0.036). Mental health domains (vitality, social functioning, psychical health) were significantly inversely related with neurologic and psychiatric comorbidity (p = 0.002 to 0.048) and correlated with higher educational level (Spearman 0.25, p = 0.019). Neurologic and psychiatric comorbidities and socio-demographic parameters are significant risk factors for a reduced QOL concerning physical and mental health in young adults with TGA after ASO. Standardized QOL measurement should be part of routine screening programs to detect subclinical physical, neurodevelopmental, and psychosocial comorbidity.

摘要

评估非心脏合并症和社会人口因素与身心健康相关生活质量(QOL)的关系,在大动脉转位(TGA)新生儿动脉切换手术后,年轻人的 QOL (SF-36)部分发现处于较高风险中。在一项前瞻性重新评估研究中,对 92 名未经选择的年轻成年人(22.8±2.6 岁)进行 QOL(SF-36)评估的结果与非心脏合并症有关,特别是神经和精神合并症与社会人口参数有关。神经合并症(14%)与精神合并症(6.5%)相比更为常见。与一般人群相比,受教育程度更高,失业率是一般人群的两倍。身体健康领域(身体机能和总体健康感知)与非心脏、神经和精神合并症之间存在显著负相关(p=0.006 至 0.033),以及后两个领域与社会经济地位、教育水平和较差的就业状况之间存在相关性(Spearman 0.22-0.41,p<0.0001 至 0.036)。心理健康领域(活力、社会功能、心理健康)与神经和精神合并症呈显著负相关(p=0.002 至 0.048),与较高的教育水平相关(Spearman 0.25,p=0.019)。神经和精神合并症以及社会人口因素是 TGA 后接受 ASO 的年轻人身心健康 QOL 降低的重要危险因素。标准化 QOL 测量应作为常规筛查计划的一部分,以检测亚临床的身体、神经发育和社会心理合并症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b33e/9986210/1135ea58e5d2/380_2022_2188_Fig1_HTML.jpg

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