Abstract 17395: Health Related Quality of Life in Patients with Congenital Heart Disease: a Meta-Analysis
Background: With improving survival rates the focus of attention in congenital heart disease (CHD) has shifted from mortality to morbidity, functional capacity and quality of life (QoL). Due to the heterogeneity of methods and results from relatively small individual trials that have assessed QoL in the past, the impact of CHD complexity on QoL remains unclear.
Methods/Results: We performed a systematic review of studies that report primary data from interviews/questionnaires for QoL. Overall, 234 studies were included in the analysis. In total, results of more than 47,400 CHD patients (46% females) at an average age of 24 years were reported. Across all studies, more than 90 different questionnaires were utilized to evaluate different aspects of QoL, with 38% of studies combining ≥2 questionnaires in one study. The most commonly used questionnaire was the SF36 form (70 studies). When combining data on QoL from publications employing the SF36 using a ratio of the means method, we found that QoL in two domains was reduced in patients with moderate or complex CHD: Compared with healthy patients, CHD patients scored lower in Physical Functioning (0.96 [0.93-0.99] and 0.91 [0.88-0.95] for medium and high complexity;p<0.01) and General Health (0.95 [0.91;0.99] and 0.91 [0.86;0.95];p<0.01). No such effect was evident in those patients with simple cardiac lesions or in the other domains of the SF36 (see Figure).
Conclusions: Despite an exponentially increasing number of QoL studies in CHD, no standardized approach for measuring and reporting QoL has emerged and the published results are heterogeneous. In aggregation, however, our results suggest that QoL is impaired in CHD patients with moderate or complex CHD, while no such impact could be established in patients with simple defects. To improve comparability between studies, standardizing measurement of QoL in CHD is required and should be attempted.
Author Disclosures: P.C. Kahr: None. R.M. Radke: None. S. Orwat: None. H. Baumgartner: None. G. Diller: None.
- © 2014 by American Heart Association, Inc.