Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jan;166(1):132-8.
doi: 10.1016/j.jpeds.2014.09.034. Epub 2014 Oct 28.

Predictors of health-related quality of life in adolescents with tetralogy of Fallot

Ashley E Neal  1 , Christian Stopp  2 , David Wypij  3 , David C Bellinger  4 , Carolyn Dunbar-Masterson  2 , David R DeMaso  5 , Jane W Newburger  1
Affiliations

Predictors of health-related quality of life in adolescents with tetralogy of Fallot

Ashley E Neal et al. J Pediatr. 2015 Jan.

Abstract

Objective: To assess health-related quality of life (HRQoL) of adolescents with repaired tetralogy of Fallot (TOF) and whether impairments in HRQoL domains are associated with neurocognitive and medical factors.

Study design: Parents of subjects with TOF and healthy referents 13-16 years of age completed the Child Health Questionnaire-Parent Form 50, generating psychosocial (PsS) and physical (PhS) health summary scores. Adolescents completed the Child Health Questionnaire-Child Form 87 and concurrent in-person neurocognitive testing. We analyzed relationships of PsS and PhS scores with neurocognitive performance and medical factors.

Results: Compared with referents (n = 85), adolescents with TOF without a genetic diagnosis (n = 66) had lower PsS (50.9 ± 9.4 vs 57.2 ± 4.2, P < .001) and PhS scores (49.4 ± 9.5 vs 55.8 ± 4.9; P < .001). Compared with a normative sample, these adolescents with TOF had similar PsS scores (P = .52) but significantly lower PhS scores (P = .01). Within adolescents with TOF without genetic disorders, lower PsS scores were highly associated with worse neurocognitive measures, particularly the parent-reported Behavior Rating Inventory of Executive Function composite (r = -0.66, P < .001) and Parent Conners' attention deficit-hyperactivity disorder Index T score (r = -0.54, P < .001), whereas associations of PhS scores with neurocognitive measures were weaker.

Conclusions: Psychosocial health status in adolescents with TOF without genetic disorders was worse than in healthy referents without risk factors for brain injury but similar to a normative sample; physical health status was worse in these adolescents than in either comparison group. Within these subjects with TOF, worse psychosocial health status was most highly associated with concurrent executive dysfunction and attention deficit-hyperactivity disorder. Optimizing HRQoL constitutes another indication for attention to neurodevelopment in children with congenital heart disease.

PubMed Disclaimer

References

    1. Report of the New England Infant Cardiac Program. Pediatrics. 1980;65:375–461. - PubMed
    1. Loffredo CA. Epidemiology of cardiovascular malformations: Prevalence and risk factors. Am J Med Genet. 2000;97:319–25. - PubMed
    1. Keith JD, Rowe RD, Vlad P. Heart disease in infancy and childhood. New York: Macmillan; 1978.
    1. Lillehei CW, Varco RL, Cohen M, Warden HE, Gott VL, DeWall RA, et al. The first open heart corrections of tetralogy of Fallot. A 26–31 year follow-up of 106 patients. Ann Surg. 1986;204:490–502. - PMC - PubMed
    1. Murphy JG, Gersh BJ, Mair DD, Fuster V, McGoon MD, Ilstrup DM, et al. Long-term outcome in patients undergoing surgical repair of tetralogy of Fallot. N Engl J Med. 1993;329:593–9. - PubMed

Publication types