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 in | The Journal of pediatrics Vol. 196; pp. 129 - 138.e3 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Elsevier Inc
01.05.2018
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Subjects | |
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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. |
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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. Copyright © 2018 Elsevier Inc. All rights reserved. |
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CorporateAuthor | Pediatric Acute Liver Failure Study Group |
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DOI | 10.1016/j.jpeds.2018.01.030 |
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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 |
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Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 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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PublicationTitle | The Journal of pediatrics |
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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... |
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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 |
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