Key result
Among congenital heart disease survivors, lower family income (≤$35,000) predicted a greater decline in physical functioning over 3 years (b = 0.5; 95% CI 0.2-0.8; P=0.001).
Why the study?
Complications may occur in adult congenital heart disease survivors, but changes in health-related quality of life over time had not been investigated among adolescent and young adult survivors.
Observational (n=172)
Yes
Effect estimate: b = 0.5 (95% CI 0.2-0.8)
p-value: p=0.001
Health-related quality of life significantly declines over a 3-year period in adolescent and young adult congenital heart disease survivors, particularly among those with lower family income.
Low-income congenital heart disease survivors may require closer functional monitoring; hypothesis-generating for socioeconomic interventions.
BACKGROUND: Because of medical advancements, many congenital heart disease (CHD) survivors are relatively symptom-free until adulthood, at which time complications may occur. Worsening health status likely drives a change in patient-reported outcomes, such as health-related quality of life (HRQoL), although change in HRQoL has not been investigated among adolescent and young adult CHD survivors. OBJECTIVE: The aims of the current mixed cross-sectional and longitudinal study were to (1) examine changes in HRQoL over 3 years and (2) identify any demographic (age, sex, estimated family income, and distance from medical center) and medical predictors (functional status and number of cardiac-related medications) of that change. METHODS: Baseline and 3-year follow-up data were obtained via an online survey of 172 CHD survivors (15-39 years old at baseline; 25% simple, 45% moderate, 30% complex) recruited from a pediatric hospital and an adult hospital. Medical predictors were abstracted from electronic medical records. RESULTS: After controlling for New York Heart Association functional class, mixed-effects models identified significant declines in all subscales of the Research and Development Corporation 36-Item Health Survey 1.0 across the 3-year timeframe. A lower estimated family income (≤$35 000) predicted more decline in physical functioning (b = 0.5, 95% confidence interval, 0.2-0.8; P = .001) and emotional functioning (b = 0.3, 95% confidence interval, 0.1-0.5; P = .017). No other significant demographic or medical predictors were identified. CONCLUSIONS: Study findings highlight the importance of tracking patient-reported outcomes over time, suggesting that medical staff should discuss HRQoL with CHD survivors during late adolescence and early adulthood before decline.
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Jackson et al. (2020) conducted an observational in Congenital heart disease (CHD) (n=172). Lower estimated family income (≤$35 000) vs. Higher estimated family income was evaluated on Decline in physical functioning (b = 0.5, 95% CI 0.2-0.8, p=0.001). Among congenital heart disease survivors, lower family income (≤$35,000) predicted a greater decline in physical functioning over 3 years (b = 0.5; 95% CI 0.2-0.8; P=0.001).