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Impact of Surgical Complexity on Health-Related Quality of Life in Congenital Heart Disease Surgical Survivors

O'Connor, AM; Wray, J; Tomlinson, RS; Cassedy, A; Jacobs, JP; Jenkins, KJ; Brown, KL; ... Marino, BS; + view all (2016) Impact of Surgical Complexity on Health-Related Quality of Life in Congenital Heart Disease Surgical Survivors. Journal of the American Heart Association , 5 (7) , Article e001234. 10.1161/JAHA.114.001234. Green open access

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Abstract

BACKGROUND: Surgical complexity and related morbidities may affect long‐term patient quality of life (QOL). Aristotle Basic Complexity (ABC) score and Risk Adjustment in Congenital Heart Surgery (RACHS‐1) category stratify the complexity of pediatric cardiac operations. The purpose of this study was to examine the relationship between surgical complexity and QOL and to investigate other demographic and clinical variables that might explain variation in QOL in pediatric cardiac surgical survivors. METHODS AND RESULTS: Pediatric Cardiac Quality of Life (PCQLI) study participants who had undergone cardiac surgery were included. The PCQLI database provided sample characteristics and QOL scores. Surgical complexity was defined by the highest ABC raw score or RACHS‐1 category. Relationships among surgical complexity and demographic, clinical, and QOL variables were assessed using ordinary least squares regression. A total of 1416 patient–parent pairs were included. Although higher ABC scores and RACHS‐1 categories were associated with lower QOL scores (P<0.005), correlation with QOL scores was poor to fair (r=−0.10 to −0.29) for all groups. Ordinary least squares regression showed weak association with R2=0.06 to R2=0.28. After accounting for single‐ventricle anatomy, number of doctor visits, and time since last hospitalization, surgical complexity scores added no additional explanation to the variance in QOL scores. CONCLUSIONS: ABC scores and RACHS-1 categories are useful tools for morbidity and mortality predictions prior to cardiac surgery and quality of care initiatives but are minimally helpful in predicting a child’s or adolescent’s long-term QOL scores. Further studies are warranted to determine other predictors of QOL variation.

Type: Article
Title: Impact of Surgical Complexity on Health-Related Quality of Life in Congenital Heart Disease Surgical Survivors
Open access status: An open access version is available from UCL Discovery
DOI: 10.1161/JAHA.114.001234
Publisher version: http://dx.doi.org/10.1161/JAHA.114.001234
Language: English
Additional information: © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Keywords: Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Cardiovascular System & Cardiology, Aristotle Basic Complexity, congenital heart disease surgery, quality of life, Risk Adjustment in Congenital Heart Surgery, CATEGORIES REFLECT MORTALITY, CORRECTIVE CARDIAC-SURGERY, VENTRICULAR SEPTAL-DEFECT, CIRCULATORY ARREST, GREAT-ARTERIES, CHILDREN, ADOLESCENTS, RISK, POPULATION, ADJUSTMENT
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
URI: https://discovery.ucl.ac.uk/id/eprint/10058002
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