Health Related Quality of Life and Neurocognitive Outcomes in the First Year after Pediatric Acute Liver Failure

To determine health-related quality of life (HRQoL) and neurocognitive impairment in survivors of pediatric acute liver failure (PALF). A longitudinal prospective study was conducted. At 6 and 12 months after PALF presentation, surveys of HRQoL were completed for 2- to 19-year-olds and executive fun...

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Published inThe Journal of pediatrics Vol. 196; pp. 129 - 138.e3
Main Authors Sorensen, Lisa G., Neighbors, Katie, Hardison, Regina M., Loomes, Kathleen M., Varni, James W., Ng, Vicky L., Squires, Robert H., Alonso, Estella M., Bukauskas, Kathryn, Schulte, Madeline, Narkewicz, Michael R., Hite, Michelle, Rand, Elizabeth B., Piccoli, David, Kawchak, Deborah, Seidman, Christa, Romero, Rene, Karpen, Saul, de la Cruz-Tracy, Liezl, Hunt, Kelsey, Subbarao, Girish C., Klipsch, Ann, Munson, Sarah, Kelly, Susan, Rosenthal, Philip J., Fleck, Shannon, Leonis, Mike A., Bucuvalas, John, Horning, Tracie, Baez, Norberto Rodriguez, Montanye, Shirley, Cowie, Margaret, Horslen, Simon P., Murray, Karen, Young, Melissa, Nielson, Heather, Klein, Jani, Rudnick, David A., Shepherd, Ross W., Harris, Kathy, Karpen, Saul J., De La Torre, Alejandro, Dell Olio, Dominic, Kelly, Deirdre, Lloyd, Carla, Lobritto, Steven J., Bakhsh, Sumerah, Jonas, Maureen, Elifoson, Scott A., Raza, Roshan, Schwarz, Kathleen B., Karnsakul, Wikrom W., Alford, Mary Kay, Dhawan, Anil, Fitzpatrick, Emer, Kerkar, Nanda N., Haydel, Brandy, Narayanappa, Sreevidya, Lopez, M. James, Shieck, Victoria
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.05.2018
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Abstract To determine health-related quality of life (HRQoL) and neurocognitive impairment in survivors of pediatric acute liver failure (PALF). A longitudinal prospective study was conducted. At 6 and 12 months after PALF presentation, surveys of HRQoL were completed for 2- to 19-year-olds and executive functioning for ages 2-16 years. At 12 months, patients 3-16 years of age completed neurocognitive testing. HRQoL scores were compared with a healthy, matched sample. Neurocognitive scores were compared with norms; executive functioning scores were examined categorically. A total of 52 parent-report HRQoL surveys were completed at 6 months, 48 at 12 months; 25 patients completed neurocognitive testing. The median age at 6 months was 7.9 years (range 3.5-15.0), and final diagnosis was indeterminate for 46.2% (n = 24). Self and parent-report on Pediatric Quality of Life Inventory Generic and Multidimensional Fatigue scales fell below the healthy sample at 6 months and 12 months (almost all P < .001). Children reported lower mean scores on cognitive fatigue at 12 months (60.91 ± 22.99) compared with 6 months (73.61 ± 27.49, P = .006) . The distribution of Behavior Rating Inventory of Executive Function scores was shifted downward on parent-report (preschool) for all indices at 6 months (n = 14, P ≤ .003); Global Executive Composite and Emergent Metacognition at 12 months (n = 10, P = .03). Visual Motor Integration (VMI-6) Copying (mean = 90.3 ± 13.8, P = .0002) and VMI-6 Motor Coordination (mean = 85.1 ± 15.2 P = .0002) fell below norms, but full scale IQ (Wechsler Scales) and Attention (Conners' Continuous Performance Test) did not. Survivors of PALF appear to show deficits in motor skills, executive functioning, HRQoL, and evidence for worsening cognitive fatigue from 6 to 12 months following PALF presentation.
AbstractList To determine health-related quality of life (HRQoL) and neurocognitive impairment in survivors of pediatric acute liver failure (PALF). A longitudinal prospective study was conducted. At 6 and 12 months after PALF presentation, surveys of HRQoL were completed for 2- to 19-year-olds and executive functioning for ages 2-16 years. At 12 months, patients 3-16 years of age completed neurocognitive testing. HRQoL scores were compared with a healthy, matched sample. Neurocognitive scores were compared with norms; executive functioning scores were examined categorically. A total of 52 parent-report HRQoL surveys were completed at 6 months, 48 at 12 months; 25 patients completed neurocognitive testing. The median age at 6 months was 7.9 years (range 3.5-15.0), and final diagnosis was indeterminate for 46.2% (n = 24). Self and parent-report on Pediatric Quality of Life Inventory Generic and Multidimensional Fatigue scales fell below the healthy sample at 6 months and 12 months (almost all P < .001). Children reported lower mean scores on cognitive fatigue at 12 months (60.91 ± 22.99) compared with 6 months (73.61 ± 27.49, P = .006) . The distribution of Behavior Rating Inventory of Executive Function scores was shifted downward on parent-report (preschool) for all indices at 6 months (n = 14, P ≤ .003); Global Executive Composite and Emergent Metacognition at 12 months (n = 10, P = .03). Visual Motor Integration (VMI-6) Copying (mean = 90.3 ± 13.8, P = .0002) and VMI-6 Motor Coordination (mean = 85.1 ± 15.2 P = .0002) fell below norms, but full scale IQ (Wechsler Scales) and Attention (Conners' Continuous Performance Test) did not. Survivors of PALF appear to show deficits in motor skills, executive functioning, HRQoL, and evidence for worsening cognitive fatigue from 6 to 12 months following PALF presentation.
OBJECTIVETo determine health-related quality of life (HRQoL) and neurocognitive impairment in survivors of pediatric acute liver failure (PALF).STUDY DESIGNA longitudinal prospective study was conducted. At 6 and 12 months after PALF presentation, surveys of HRQoL were completed for 2- to 19-year-olds and executive functioning for ages 2-16 years. At 12 months, patients 3-16 years of age completed neurocognitive testing. HRQoL scores were compared with a healthy, matched sample. Neurocognitive scores were compared with norms; executive functioning scores were examined categorically.RESULTSA total of 52 parent-report HRQoL surveys were completed at 6 months, 48 at 12 months; 25 patients completed neurocognitive testing. The median age at 6 months was 7.9 years (range 3.5-15.0), and final diagnosis was indeterminate for 46.2% (n = 24). Self and parent-report on Pediatric Quality of Life Inventory Generic and Multidimensional Fatigue scales fell below the healthy sample at 6 months and 12 months (almost all P < .001). Children reported lower mean scores on cognitive fatigue at 12 months (60.91 ± 22.99) compared with 6 months (73.61 ± 27.49, P = .006) . The distribution of Behavior Rating Inventory of Executive Function scores was shifted downward on parent-report (preschool) for all indices at 6 months (n = 14, P ≤ .003); Global Executive Composite and Emergent Metacognition at 12 months (n = 10, P = .03). Visual Motor Integration (VMI-6) Copying (mean = 90.3 ± 13.8, P = .0002) and VMI-6 Motor Coordination (mean = 85.1 ± 15.2 P = .0002) fell below norms, but full scale IQ (Wechsler Scales) and Attention (Conners' Continuous Performance Test) did not.CONCLUSIONSSurvivors of PALF appear to show deficits in motor skills, executive functioning, HRQoL, and evidence for worsening cognitive fatigue from 6 to 12 months following PALF presentation.
Author Loomes, Kathleen M.
Montanye, Shirley
Ng, Vicky L.
Fleck, Shannon
Alford, Mary Kay
Kawchak, Deborah
Bucuvalas, John
Karpen, Saul J.
Karpen, Saul
Subbarao, Girish C.
Lopez, M. James
Kelly, Susan
Harris, Kathy
Jonas, Maureen
Horning, Tracie
Squires, Robert H.
Cowie, Margaret
Dhawan, Anil
Bakhsh, Sumerah
Romero, Rene
Klipsch, Ann
Rosenthal, Philip J.
Lloyd, Carla
Shepherd, Ross W.
Rudnick, David A.
Leonis, Mike A.
Hite, Michelle
Lobritto, Steven J.
Karnsakul, Wikrom W.
Kerkar, Nanda N.
Shieck, Victoria
Alonso, Estella M.
Schwarz, Kathleen B.
Haydel, Brandy
Murray, Karen
Kelly, Deirdre
Nielson, Heather
Baez, Norberto Rodriguez
Narayanappa, Sreevidya
Young, Melissa
Narkewicz, Michael R.
Fitzpatrick, Emer
Varni, James W.
Rand, Elizabeth B.
Seidman, Christa
Hunt, Kelsey
Schulte, Madeline
Dell Olio, Dominic
Horslen, Simon P.
Hardison, Regina M.
Elifoson, Scott A.
Klein, Jani
Sorensen, Lisa G.
Piccoli, David
De La Torre, Alejandro
Neighbors, Katie
de la Cruz-Tracy, Liezl
Bukauskas, Kathryn
Munson, Sarah
Raza, Roshan
AuthorAffiliation 1 Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA; Child & Adolescent Psychiatry
5 Texas A&M University, College Station, TX, USA; Pediatrics
6 Hospital for Sick Children, University of Toronto, ON, Canada; Division of Paediatric Gastroenterology, Hepatology and Nutrition
4 University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Division of Gastroenterology, Hepatology and Nutrition, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA; Pediatrics
2 Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA; Pediatrics
3 University of Pittsburgh, Pittsburgh, PA, USA; Epidemiology
7 University of Pittsburgh, Pittsburgh, PA, USA; Pediatrics
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/29551316$$D View this record in MEDLINE/PubMed
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ContentType Journal Article
Contributor Montanye, Shirley
Leonis, Mike A
Fleck, Shannon
Alford, Mary Kay
Rudnick, David A
Kawchak, Deborah
Bucuvalas, John
Karpen, Saul
Kelly, Susan
Schwarz, Kathleen B
Harris, Kathy
Karpen, Saul J
Jonas, Maureen
Horning, Tracie
Cowie, Margaret
Dhawan, Anil
Bakhsh, Sumerah
Romero, Rene
Lopez, M James
Klipsch, Ann
Subbarao, Girish C
Lloyd, Carla
Horslen, Simon P
Rand, Elizabeth B
Hite, Michelle
Kerkar, Nanda N
Narkewicz, Michael R
Shieck, Victoria
Haydel, Brandy
Murray, Karen
Kelly, Deirdre
Nielson, Heather
Baez, Norberto Rodriguez
Narayanappa, Sreevidya
Young, Melissa
Fitzpatrick, Emer
Seidman, Christa
Hunt, Kelsey
Lobritto, Steven J
Schulte, Madeline
Rosenthal, Philip J
Dell Olio, Dominic
Karnsakul, Wikrom W
Shepherd, Ross W
Klein, Jani
Piccoli, David
Elifoson, Scott A
De La Torre, Alejandro
de la Cruz-Tracy, Liezl
Bukauskas, Kathryn
Munson, Sarah
Raza, Roshan
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Copyright 2018 Elsevier Inc.
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Keywords APAP
cognitive fatigue
WPPSI-IV
CPT-II
PALFSG
VMI-6
PALF
PTSD
BRIEF
pediatric liver disease
K-CPT
ABAS-II
PedsQL MFS
WISC-IV
HRQoL
executive functioning
pediatric liver transplantation
CDI-2
HE
PedsQL
cognition disorders
Language English
License Copyright © 2018 Elsevier Inc. All rights reserved.
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content type line 23
List of additional members of the Pediatric Acute Liver Failure Study Group is available at www.jpeds.com (Appendix)
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Snippet To determine health-related quality of life (HRQoL) and neurocognitive impairment in survivors of pediatric acute liver failure (PALF). A longitudinal...
OBJECTIVETo determine health-related quality of life (HRQoL) and neurocognitive impairment in survivors of pediatric acute liver failure (PALF).STUDY DESIGNA...
SourceID pubmedcentral
proquest
crossref
pubmed
elsevier
SourceType Open Access Repository
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StartPage 129
SubjectTerms Adolescent
Attention
Child
Child, Preschool
Cognition
cognition disorders
Cognitive Dysfunction - diagnosis
cognitive fatigue
Cross-Sectional Studies
Depression - complications
Executive Function
executive functioning
Fatigue
Female
Humans
Infant
Infant, Newborn
Intelligence Tests
Liver Failure, Acute - psychology
Liver Failure, Acute - therapy
Longitudinal Studies
Male
Mental Status and Dementia Tests
Motor Skills
pediatric liver disease
pediatric liver transplantation
Prospective Studies
Quality of Life
Stress Disorders, Post-Traumatic - complications
Treatment Outcome
Young Adult
Title Health Related Quality of Life and Neurocognitive Outcomes in the First Year after Pediatric Acute Liver Failure
URI https://dx.doi.org/10.1016/j.jpeds.2018.01.030
https://www.ncbi.nlm.nih.gov/pubmed/29551316
https://search.proquest.com/docview/2015409797
https://pubmed.ncbi.nlm.nih.gov/PMC5933443
Volume 196
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