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Regional variation in quality of life in patients with a Fontan circulation: A multinational perspective
Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
KU Leuven Department of Public Health and Primary Care, Leuven, Belgium.
KU Leuven Department of Public Health and Primary Care, Leuven, Belgium.
Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
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2017 (English)In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 193, no Supplement C, 55-62 p.Article in journal (Refereed) Published
Abstract [en]

BackgroundImpaired quality of life (QOL) is associated with congenital heart disease (CHD) and country of residence; however, few studies have compared QOL in patients with differing complexities of CHD across regional populations. The current study examined regional variation in QOL outcomes in a large multinational sample of patients with a Fontan relative to patients with atrial septal defects (ASDs) and ventricular septal defects (VSDs).MethodsFrom the Assessment of Patterns of Patient-Reported Outcomes in Adults with Congenital Heart disease—International Study (APPROACH-IS), 405 patients (163 Fontan and 242 ASD/VSD) across Asia, Europe, and North America provided consent for access to their medical records and completed a survey evaluating QOL (0 to 100 linear analog scale). Primary CHD diagnosis, disease complexity, surgical history, and documented history of mood and anxiety disorders were recorded. Differences in QOL, medical complications, and mood and anxiety disorders between Fontan and ASD/VSD patients, and across geographic regions, were examined using analysis of covariance. Hierarchical regression analyses were conducted to identify variables associated with the QOL ratings.ResultsPatients with a Fontan reported significantly lower QOL, and greater medical complications and mood and anxiety disorders relative to patients with ASD/VSD. Inpatient cardiac admissions, mood disorders, and anxiety disorders were associated with lower QOL among patients with a Fontan, and mood disorders were associated with lower QOL among patients with ASD/VSD. Regional differences for QOL were not observed in patients with a Fontan; however, significant differences were identified in patients with ASD/VSD.ConclusionsRegional variation of QOL is commonplace in adults with CHD; however, it appears affected by greater disease burden. Among patients with a Fontan, regional variation of QOL is lost. Specific attempts to screen for QOL and mood and anxiety disorders among CHD patients may improve the care of patients with the greatest disease burden.

Place, publisher, year, edition, pages
2017. Vol. 193, no Supplement C, 55-62 p.
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-11582DOI: 10.1016/j.ahj.2017.07.019ISI: 000415058800007PubMedID: 29129255Scopus ID: 2-s2.0-85028920376OAI: oai:DiVA.org:hv-11582DiVA: diva2:1142663
Available from: 2017-09-19 Created: 2017-09-19 Last updated: 2017-12-05Bibliographically approved

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Berghammer, Malin

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