Document Detail


Functional limitations in young children with congenital heart defects after cardiac surgery.
MedLine Citation:
PMID:  11731655     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
With the recent dramatic decline in mortality rates of infants undergoing open-heart surgery (OHS), there is growing concern regarding neurodevelopmental sequelae. Outcome studies have primarily focused on delineating developmental impairments; however, the impact on function and family burden has not been investigated. The objective of this study was to determine the prevalence of functional limitations and burden of care of young children with congenital heart defects (CHD) after OHS. STUDY DESIGN: One hundred thirty-one eligible infants with CHD undergoing their first OHS were recruited prospectively. Patients were assessed pre- and postoperatively, and again 12 to 18 months after surgery. Functional assessments included the WeeFIM (Functional Independence Measure) and the Vineland Adaptive Behavior Scale. RESULTS: For the WeeFIM, mean quotients were 84.3 +/- 23.8 (self-care), 77.2 +/- 30.0 (mobility), and 92.4 +/- 27.8 (cognition), with an overall quotient of 83.8 +/- 23.4. Only 21% of the cohort was functioning within their expected age range. Moderate disability was noted in 37%, while only 6% demonstrated a severe disability. For the Vineland scale, mean score for daily living skills was 84.4 +/- 17.6, and 80.3 +/- 15.9 for socialization. Functional difficulties in daily living skills were documented in 40%, whereas >1/2 had poor socialization skills. Factors enhancing risk for functional disabilities included perioperative neurodevelopmental status, microcephaly, length of deep hypothermic circulatory arrest, length of stay in the intensive care unit, age at surgery, and maternal education. CONCLUSIONS: The high prevalence of functional limitations and dependence in activities of daily living is currently underappreciated in the clinical setting, and deserves additional attention by pediatricians and developmental specialists.
Authors:
C Limperopoulos; A Majnemer; M I Shevell; B Rosenblatt; C Rohlicek; C Tchervenkov; H Z Darwish
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pediatrics     Volume:  108     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2001-12-03     Completed Date:  2002-01-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1325-31     Citation Subset:  AIM; IM    
Affiliation:
School of Physical and Occupational Therapy, McGill University, Montreal Children's Hospital, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living*
Cardiopulmonary Bypass
Cardiovascular Surgical Procedures*
Child, Preschool
Cost of Illness*
Developmental Disabilities / epidemiology*
Heart Arrest, Induced
Heart Defects, Congenital / surgery*
Humans
Infant
Prospective Studies
Regression Analysis
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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