Assessment of Quality of Life in Young Patients with Single Ventricle after the Fontan Operation

• Published in: The Journal of pediatrics Vol. 170; pp. 166 - 172.e1
• Main Authors: Uzark, Karen, PhD, CPNP, Zak, Victor, PhD, Shrader, Peter, MA, McCrindle, Brian W., MD, MPH, Radojewski, Elizabeth, RN, Varni, James W., PhD, Daniels, Kaitlyn, BSN, RN, Handisides, Jill, BSN, Hill, Kevin D., MD, MS, Lambert, Linda M., MSN, FNP, Margossian, Renee, MD, Pemberton, Victoria L., RNC, MS, CCRC, Lai, Wyman W., MD, Atz, Andrew M., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.03.2016
• Subjects: Adolescent; Adult; Age Factors; Cross-Sectional Studies; Female; Follow-Up Studies; Fontan Procedure - psychology; Humans; Male; Pediatrics; Quality of Life; Surveys and Questionnaires; Survivors; United States - epidemiology; Young Adult; United States; Pediatric Quality of Life Inventory; Short Form Health Survey; Fontan Follow-up Study; Pediatric Heart Network Fontan Cross-Sectional Study; Fontan 2; Fontan 1; Congenital heart disease; Child Health Questionnaire; QOL; Quality of life; SF-36; CHQ-87; PedsQL; CHD
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2015.11.016

Objectives To assess self-reported quality of life (QOL) in a large multicenter cohort of adolescent and young adults surviving Fontan. Study design Cross-sectional. The Pediatric Quality of Life Inventory (PedsQL) was administered to 408 survivors of Fontan ages 13-25 years enrolled in the Pediatric Heart Network Fontan Follow-up Study. Subjects also completed either the Child Health Questionnaire (age <19 years) or Short Form Health Survey (age ≥19 years). PedsQL data were compared with matched controls without a chronic health condition. Correlations between the measures were examined. Results Mean PedsQL scores for subjects receiving Fontan were significantly lower than those for the control group for physical and psychosocial QOL ( P  < .001). Overall, 45% of subjects receiving Fontan had scores in the clinically significant impaired range for physical QOL with 30% in the impaired range for psychosocial QOL. For each 1 year increase in age, the physical functioning score decreased by an average of 0.76 points ( P  = .004) and the emotional functioning score decreased by an average of 0.64 points ( P  = .03). Among subjects ≥19 years of age, the physical functioning score decreased by an average of 2 points for each year increase in age ( P  = .02). PedsQL scale scores were significantly correlated with conceptually related Child Health Questionnaire ( P  < .001) and Short Form Health Survey scores ( P  < .001). Conclusions Survivors of Fontan are at risk for significantly impaired QOL which may decline with advancing age. Routine assessment of QOL is essential to inform interventions to improve health outcomes. The PedsQL allowed QOL assessment from pediatrics to young adulthood. Trial registration ClinicalTrials.gov : NCT00132782.