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Morbidities following cardiac surgery: impact on children's quality of life and parent mental health

Wray, J; Ridout, D; Jones, A; Davis, P; Wellman, P; Rodrigues, W; Hudson, E; ... Brown, KL; + view all (2020) Morbidities following cardiac surgery: impact on children's quality of life and parent mental health. The Annals of Thoracic Surgery 10.1016/j.athoracsur.2020.11.003. (In press).

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Abstract

BACKGROUND: The majority of children now survive cardiac surgery, and the focus of quality improvement initiatives has shifted towards more complex outcome measures. Our aim was to study the impact of early post-operative morbidities on parent-reported patient quality of life and parental anxiety/depression over six months. METHODS: We undertook a prospective case matched cohort study in five UK children's cardiac centers, in which we compared measures of impact for patient categories of 'single morbidity', 'multiple morbidities' and 'extracorporeal life support (ECLS)' with 'no morbidity'. Measures were PedsQL and PHQ-4 at six weeks and six months post-surgery. We modelled the outcomes using mixed effects regression, adjusting for case mix and clustering within centers. RESULTS: We included 666 patients, operated at a median age of 81 days (IQR 10-325 days). At six weeks follow-up, significant adjusted differences to the reference group with no morbidity were found for total PedsQL scores, which were lower in ECLS (p=0.01), multiple morbidities (p<0.001) and single morbidity (p=0.04); and the proportion of parents with anxiety and depression, which were higher in multiple morbidities (p=0.04 and p=0.01 respectively). At six months, measures had improved in all morbidity groups: the only significant adjusted difference to the reference group was for physical PedsQL scores in ECLS (p=0.04) and multiple morbidities (p<0.01). CONCLUSIONS: Patient and parent wellbeing are strongly influenced by post-operative morbidities early after surgery, with improvement by six months. Family psychological support and holistic rehabilitation are vital for children who experience post-operative morbidities.

Type: Article
Title: Morbidities following cardiac surgery: impact on children's quality of life and parent mental health
Location: Netherlands
DOI: 10.1016/j.athoracsur.2020.11.003
Publisher version: https://doi.org/10.1016/j.athoracsur.2020.11.003
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
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 Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Mathematics
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Maths and Physical Sciences > Dept of Mathematics > Clinical Operational Research Unit
URI: https://discovery.ucl.ac.uk/id/eprint/10116882
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