O'Byrne Michael L, Sharma Priya, Huang Jing, Smith Christopher L, Tang Jie, Callahan Ryan, Edelson Jonathan B, Dori Yoav, Gillespie Matthew J, Rome Jonathan J, Glatz Andrew C
Division of Cardiology, The Children's Hospital of Philadelphia and Department of Pediatrics Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA; Clinical Futures, The Children's Hospital of Philadelphia, Philadelphia PA; Leonard Davis Institute and Center for Cardiovascular Outcomes, Qulaity, and Evaluative Research, The University of Pennsylvania, Philadelphia, PA.
Data Science and Biostatistics Unit, The Children's Hospital of Philadelphia, Philadelphia PA.
Am Heart J. 2025 Mar;281:71-83. doi: 10.1016/j.ahj.2024.11.017. Epub 2024 Dec 4.
Health related quality of life (HRQOL) is a patient-reported metric (PRM) that provides a holistic measure of health that is not addressed in traditional outcome measures. The acute responsiveness of HRQOL after pediatric/congenital cardiac catheterization procedures has not, to our knowledge, been studied.
A single-center prospective cohort study was performed, longitudinally evaluating HRQOL and other PRM in school-age children and adolescents (ages 8-18) undergoing diagnostic and interventional cardiac catheterization procedures prior to their scheduled procedure, and then 1 day, ∼1 month, and ∼3 months after the procedure. Differences between HRQOL at baseline and at 1- and 3-month follow-up were evaluated using paired Student's t-tests.
A total of 70 patient-parent/guardian dyads were studied. The participating patients were 13±3 years old, 51% female, and 74% non-Hispanic white, with 54% undergoing a diagnostic procedure. The trajectory of cardiac-specific HRQOL as measured through Pediatric Cardiac Quality of Life Inventory differed for patients undergoing diagnostic and interventional procedures. Following diagnostic procedures, there was no significant change in cardiac-specific HRQOL (P > .05). After interventional procedures, patient-reported cardiac-specific HRQOL increased at both 1-month (4.3±11, P = .04) and 3-months (5.9±11.4, P = .02), though the same changes were not seen in parent/guardian-reported cardiac-specific HRQOL (P > .05). PROMIS measures of physical function, psychological symptoms, and social function were associated with baseline cardiac-specific HRQOL (all P < .05), but no associations were seen between other patient-reported outcomes and baseline HRQOL or change from baseline to 3-month follow-up.
Across a range of transcatheter interventional procedures, patient-reported cardiac-specific HRQOL improved in short term follow up, though these changes were not seen in parent/guardian reported measures. Incorporating these patient-centered metrics into evaluation of transcatheter therapies may provide more accurate measures of comparative effectiveness.
健康相关生活质量（HRQOL）是一种患者报告指标（PRM），它提供了一种传统结局指标未涉及的整体健康衡量方法。据我们所知，尚未对儿科/先天性心脏导管插入术后HRQOL的急性反应性进行研究。
进行了一项单中心前瞻性队列研究，纵向评估计划接受诊断性和介入性心脏导管插入术的学龄儿童和青少年（8至18岁）在预定手术前以及术后1天、约1个月和约3个月的HRQOL和其他PRM。使用配对学生t检验评估基线时与1个月和3个月随访时HRQOL的差异。
共研究了70对患者-父母/监护人二元组。参与研究的患者年龄为13±3岁，51%为女性，74%为非西班牙裔白人，54%接受诊断性手术。通过儿科心脏生活质量量表测量的心脏特异性HRQOL轨迹在接受诊断性和介入性手术的患者中有所不同。诊断性手术后，心脏特异性HRQOL无显著变化（P>.05）。介入性手术后，患者报告的心脏特异性HRQOL在1个月时（4.3±11，P=.04）和3个月时（5.9±11.4，P=.02）均有所增加，尽管父母/监护人报告的心脏特异性HRQOL未见相同变化（P>.05）。身体功能、心理症状和社会功能的PROMIS测量与基线心脏特异性HRQOL相关（均P<.05），但其他患者报告结局与基线HRQOL或从基线到3个月随访的变化之间未见关联。
在一系列经导管介入手术中，患者报告的心脏特异性HRQOL在短期随访中有所改善，尽管父母/监护人报告的测量中未见这些变化。将这些以患者为中心的指标纳入经导管治疗的评估中可能会提供更准确的比较有效性测量。
