Dumitru Andrada Ioana, Kis Andreea Mihaela, Badea Mihail-Alexandru, Lacatusu Adrian, Boia Marioara
Doctoral School, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, "Victor Babes" University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania.
Healthcare (Basel). 2025 Aug 1;13(15):1882. doi: 10.3390/healthcare13151882.
: Although survival after congenital cardiac malformations (CCM) has improved, little is known about Romanian children's own perceptions of health-related quality of life (HRQoL) or their emotional burden. We compared HRQoL, depressive symptoms, and anxiety across lesion severity strata and explored clinical predictors of impaired HRQoL. : In this cross-sectional study (1 May 2023-30 April 2025), 72 children (mean age 7.9 ± 3.0 years, 52.8% male) attending a tertiary cardiology clinic completed the Romanian-validated Pediatric Quality of Life Inventory (PedsQL), Children's Depression Inventory (CDI) and the Screen for Child Anxiety-Related Emotional Disorders questionnaire (SCARED-C, child version). Lesions were classified as mild ( = 22), moderate ( = 34), or severe ( = 16). Left-ventricular ejection fraction (LVEF) and unplanned cardiac hospitalisations over the preceding 12 months were extracted from electronic records. : Mean PedsQL total scores declined stepwise by severity (mild 80.9 ± 7.3; moderate 71.2 ± 8.4; severe 63.1 ± 5.4; < 0.001). CDI and SCARED-C scores rose correspondingly (CDI: 9.5 ± 3.0, 13.6 ± 4.0, 18.0 ± 2.7; anxiety: 15.2 ± 3.3, 17.2 ± 3.8, 24.0 ± 3.4; both < 0.001). PedsQL correlated positively with LVEF (r = 0.51, < 0.001) and negatively with hospitalisations (r = -0.39, = 0.001), depression (r = -0.44, < 0.001), and anxiety (r = -0.47, < 0.001). In multivariable analysis, anatomical severity remained the sole independent predictor of lower HRQoL (β = -8.4 points per severity tier, < 0.001; model R = 0.45). Children with ≥ 1 hospitalisation ( = 42) reported poorer HRQoL (69.6 ± 8.0 vs. 76.1 ± 11.1; = 0.005) and higher depressive scores ( < 0.001). : HRQoL and internalising symptoms in Romanian children with CCM worsen with increasing anatomical complexity and recent hospital utilisation. The severity tier outweighed functional markers as the main determinant of HRQoL, suggesting that psychosocial screening and support should be scaled to lesion complexity. Integrating the routine use of the Romanian-validated PedsQL, CDI, and SCARED-C questionnaire into cardiology follow-up may help identify vulnerable patients early and guide targeted interventions.
尽管先天性心脏畸形（CCM）患儿的生存率有所提高，但对于罗马尼亚儿童自身对健康相关生活质量（HRQoL）的认知或他们的情感负担却知之甚少。我们比较了不同病变严重程度分层的HRQoL、抑郁症状和焦虑情况，并探讨了HRQoL受损的临床预测因素。
在这项横断面研究（2023年5月1日至2025年4月30日）中，72名在三级心脏病诊所就诊的儿童（平均年龄7.9±3.0岁，52.8%为男性）完成了经罗马尼亚验证的儿童生活质量量表（PedsQL）、儿童抑郁量表（CDI）和儿童焦虑相关情绪障碍筛查问卷（SCARED-C，儿童版）。病变被分为轻度（=22）、中度（=34）或重度（=16）。从电子记录中提取左心室射血分数（LVEF）和过去12个月内的非计划性心脏住院情况。
PedsQL总分均值随严重程度逐步下降（轻度80.9±7.3；中度71.2±8.4；重度63.1±5.4；<0.001）。CDI和SCARED-C得分相应升高（CDI：9.5±3.0，13.6±4.0，18.0±2.7；焦虑：15.2±3.3，17.2±3.8，24.0±3.4；两者均<0.001）。PedsQL与LVEF呈正相关（r = 0.51，<0.001），与住院次数呈负相关（r = -0.39，= 0.001），与抑郁（r = -0.44，<0.001）和焦虑（r = -0.47，<0.001）呈负相关。在多变量分析中，解剖学严重程度仍然是HRQoL较低的唯一独立预测因素（每严重程度层级β=-8.4分，<0.001；模型R = 0.45）。有≥1次住院经历的儿童（=42）报告的HRQoL较差（69.6±8.0 vs. 76.1±11.1；= 0.005）且抑郁得分较高（<0.001）。
患有CCM的罗马尼亚儿童的HRQoL和内化症状会随着解剖结构复杂性的增加和近期住院情况而恶化。严重程度分层作为HRQoL的主要决定因素比功能指标更重要，这表明心理社会筛查和支持应根据病变复杂性进行调整。将经罗马尼亚验证的PedsQL、CDI和SCARED-C问卷的常规使用纳入心脏病学随访可能有助于早期识别脆弱患者并指导有针对性的干预措施。
