Abstract 5710: General Health Status of Adolescents With D-Transposition of the Great Arteries After the Arterial Switch Operation
Background: The determinants of general health status in adolescents after infant congenital heart surgery are uncertain. We explored the predictors of physical and psychosocial health status in adolescents with D-TGA after the arterial switch operation (ASO), its tracking from elementary to high school, and factors influencing change in functional status. Our study population has been followed in the Boston Circulatory Arrest Study since birth.
Methods: Parents of 134 children with D-TGA completed the Child Health Questionnaire (CHQ-PF50) when their children were both ages 8 years (median=8.1 yrs) and 16 years (median=16.1 yrs). Predictor variables included medical history, sociodemographic variables, and neurodevelopmental test scores.
Results: At age 16 yrs, mean Physical Health Summary (PHS) and Psychosocial Summary (PSS) scores were 53.5±6.5 (mean±SD) and 51.8±8.7, respectively, similar to the normative sample. Parents of 16 yr D-TGA pts reported more problems with attention (41%), learning (32%), speech (28%), anxiety (15%), and developmental delay (15%) than the normative sample (all p≤.001). PHS scores could not be predicted by medical or other variables. Lower PSS scores were associated with lower social class (Spearman r=.17, p=.05), and lower scores at age 16 years in reading (r=.24, p=.005) and math achievement (r=.27, p=.002), visual-perceptual skills (r=.26, p=.002), and memory (r=.23, p=.008), and, highly, with the Connors Attention Deficit Hyperactivity Disorder (ADHD) index (r= −.65, p<.001) and global executive function (r= −.60, p<.001). PHS and PSS scores tracked from ages 8 to 16 years (r=.41 and .43, both p<.001). Deteriorating PSS scores from 8 and 16 yrs were associated with worse scores at age 16 in global executive function (r= −.19, p=.03) and ADHD index (r= −.22, p=.01), but not IQ, achievement, social class, or medical variables.
Conclusions: General health status in 16 yr olds with D-TGA after the ASO is similar to a normative sample. Psychosocial health at 16 yrs is associated with neurocognitive function at the same age and with psychosocial health at age 8 years. Decline in psychosocial health from 8 to 16 yrs is most highly related to functional domains of ADHD and executive function.