Abstract 18723: Relationship of Health-Related Quality of Life to Neurodevelopmental Function in Fontan Adolescents
Background: Health-related quality of life (QOL) in Fontan patients has been shown to be related to patient and medical characteristics as well as to parent-reported problems with learning and behavior. However, no studies have examined the relationships of QOL to specific neurodevelopmental (ND) domains measured with concurrent in-person testing during adolescence.
Hypothesis: Worse QOL will be related to specific ND disabilities.
Methods: Parents of 152 Fontan patients (14.5±2.9y) and 107 local referent subjects (15.3±1.8y) completed the Child Health Questionnaire, generating summary scores for psychosocial (PsS) and physical (PhS) functioning. Subjects also underwent concurrent in-person testing with a battery of ND tests.
Results: Fontan patients, compared to referents, had lower PsS scores (48.2±11.1 vs. 57.1±4.4, P<0.001) and PhS scores (45.3±11.1 vs. 56.0±4.5, P<0.001). Even those without known genetic abnormality had lower PsS and PhS scores than referents (P<0.001 each). Lower PsS scores were highly associated with worse executive function (Behavior Rating Inventory of Executive Function, parent, r=-0.71, P<0.001) and attention (Conners ADHD T-score, parent, r=-0.68, P<0.001) after adjusting for concurrent social status, genetic abnormality, and previous Norwood procedure. Lower PsS scores were also related to lower measures of intelligence (Wechsler Intelligence Scale, Full-Scale IQ, r=0.25, P=0.002), achievement (Wechsler Individual Achievement Test, math, r=0.24, P=0.003), memory (Children’s Memory Scale, r=0.37, P<0.001; Wechsler’s Memory Scale, composite, r=0.38, p=0.03), and visual-spatial skills (Test of Visual-Perceptual Skills, composite, r=0.22, P=0.04) as well as to greater indices of depression (Child Depression Inventory Total Score, r=-0.39, P<0.001), anxiety (Revised Children’s Manifest Anxiety Scale, r=-0.29, P<0.001) and autism (Autism Spectrum Quotient, r=-0.31, P<0.001). Lower PhS scores were associated with few ND outcomes.
Conclusions: Worse psychosocial health in Fontan adolescents is highly related to worse ND performance. The strong correlations of worse psychosocial health with executive dysfunction and ADHD suggest the importance of interventions targeted to these domains.
Author Disclosures: C. Dunbar-Masterson: None. C. Stopp: None. D.C. Bellinger: None. D.L. Bernson: None. D.R. DeMaso: None. M.J. Rivkin: None. J.W. Newburger: None.
- © 2014 by American Heart Association, Inc.