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Prediction of preschool functional abilities after early complex cardiac surgery

Published online by Cambridge University Press:  30 April 2014

Gwen Y. Alton ,
Soreh Taghados ,
Ari R. Joffe ,
Charlene M. T. Robertson ,
Irina Dinu  and
the Western Canadian Pediatric Therapies Follow-Up Group
Gwen Y. Alton*
Affiliation:
Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
Soreh Taghados
Affiliation:
School of Public Health, University of Alberta, Edmonton, Alberta, Canada
Ari R. Joffe
Affiliation:
Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
Charlene M. T. Robertson
Affiliation:
Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada Pediatric Rehabilitation Outcomes Evaluation and Research Unit, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada
Irina Dinu
Affiliation:
School of Public Health, University of Alberta, Edmonton, Alberta, Canada
*
Correspondence to: G. Y. Alton, RN, MN, Rm 242C, Glen East, Glenrose Rehabilitation Hospital, 10230-111 Avenue, Edmonton, Alberta, Canada T5G 0B7. Tel: 780 735-7999, ext: 15630; Fax: 780 735-7907; E-mail: gwen.alton@albertahealthservices.ca
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Abstract

Background: It is important to identify early predictors of functional limitations in children after congenital heart surgery to optimise their independence as they prepare for school. The purpose of this study is to determine potentially modifiable predictor variables of functional abilities in pre-school children who underwent complex cardiac surgery at 6 weeks of age or earlier. Methods: This prospective inception cohort study comprised a sample of 165 survivors (63% boys) who had complex cardiac surgery (75% biventricular repairs) at Stollery Children’s Hospital, Edmonton, Alberta. We excluded children with chromosomal abnormalities. When children were 4–5 years of age, the parents completed the Adaptive Behavioral Assessment System II. Regression analysis was used to assess the association between multiple risk factors and each of the four continuous composite scores. Results: The mean scores for the practical domain and general adaptive composite score of the Adaptive Behavioural Assessment System were lower than the conceptual and social domains, with 13.3% of the children having a delay in the practical domain. There was a significant association between the general adaptive (p=0.003; 0.012), conceptual (p=0.0004; 0.042), social (p=0.0007; 0.028), and the practical (p=0.046; 0.003) domain composite scores with the mother’s education and preoperative plasma lactate, respectively. Conclusion: Maternal education may be a marker for the social context of children, and warrants societal attention to improve functional outcomes. Preoperative lactate as a potentially modifiable variable may warrant increased attention to early diagnosis and aggressive resuscitation of young infants with congenital heart disease.

Keywords

Adaptive behaviourcongenital cardiac surgerypre-school functionpredictionoutcomes
Type
Original Articles
Information
Cardiology in the Young , Volume 25 , Issue 4 , April 2015 , pp. 655 - 662
Copyright
© Cambridge University Press 2014 

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Footnotes

*

The first author position is equally shared with Soreh Taghados.

**

The Western Canadian Pediatric Therapies Follow-Up Group consists of: Patricia Blakely, Saskatoon, SK; Reg Sauvé, Calgary; Diane Moddemann, Winnipeg; Jaya Bodani, Regina, SK; Anne Synnes, Vancouver, BC.

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