Health Related Quality of Life and Neurocognitive Outcomes in the First Year after Pediatric Acute Liver Failure.
Health Related Quality of Life and Neurocognitive Outcomes in the First Year after Pediatric Acute Liver Failure.
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DOI：
10.1016/j.jpeds.2018.01.030
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发表时间：
2018-05
期刊：
影响因子：
--
通讯作者：
Pediatric Acute Liver Failure Study Group
中科院分区：
文献类型：
--
作者：
Sorensen LG;Neighbors K;Hardison RM;Loomes KM;Varni JW;Ng VL;Squires RH;Alonso EM;Pediatric Acute Liver Failure Study Group
为了确定儿童急性肝衰竭（PALF）存活者的健康相关生活质量（HRQOL）和神经认知功能障碍，进行了一项纵向前瞻性研究。在PALF出现后6个月和12个月（6个月，12个月），完成了2-19岁奥尔兹的HRQOL和2-16岁儿童的执行功能（EF）调查。在12个月时，3-16岁的患者完成了神经认知测试。将HRQOL评分与健康匹配样本进行比较。将神经认知评分与正常人进行比较;对EF评分进行分类检查。在6个月时完成了52项父母报告的HRQOL调查，在12个月时完成了48项; 25例患者完成了神经认知测试。6个月时的中位年龄为7.9岁（范围3.5- 15.0岁），46.2%（n=24）的最终诊断不确定。在6个月和12个月时，PedsQL™通用和多维疲劳量表的自我和父母报告低于健康样本（几乎所有P <0.01）。儿童在12个月时报告的认知疲劳平均评分（60.91 ±22.99）低于6个月时（73.61 ± 27.49，p=0.006）。在6个月时，所有指标的执行功能行为评定量表评分的分布在父母报告（学龄前）中向下移动（n=14，p≤0.003）;在12个月时，整体执行复合量表和紧急元认知（n=10，p=0.03）。视觉运动整合（VMI-6）能力（平均值=90.3±13.8，p=0.0002）和VMI-6运动协调（平均值=85.1 ±15.2，p=0.0002）低于正常水平，但全量表智商（韦氏量表）和注意力（康纳斯持续表现测试）没有。PALF的幸存者似乎表现出运动技能、EF、HRQOL的缺陷，并且在PALF表现后从6个月到12个月出现认知疲劳恶化的证据。
To determine health related quality of life (HRQOL) and neurocognitive impairment in SURVIVORS OF pediatric acute liver failure (PALF) A longitudinal prospective study was conducted. At 6 and 12 months (6M, 12M) after PALF presentation, surveys of HRQOL were completed for 2–19 year olds, and executive functioning (EF) for ages 2–16. At 12M, patients 3–16 years completed neurocognitive testing. HRQOL scores were compared with a healthy, matched sample. Neurocognitive scores were compared with norms; EF scores were examined categorically. 52 parent-report HRQOL surveys were completed at 6M, 48 at 12M; 25 patients completed neurocognitive testing. The median age at 6M was 7.9 years (range 3.5- 15.0), and final diagnosis was indeterminate for 46.2% (n=24). Self and parent-report on PedsQL™ Generic and Multidimensional Fatigue scales fell below the healthy sample at 6M and 12M (almost all P < 001). Children reported lower mean scores on cognitive fatigue at 12M (60.91 ±22.99) compared with 6 M (73.61 ± 27.49, p=0.006). The distribution of Behavior Rating Inventory of Executive Function scores was shifted downward on parent-report (preschool) for all indices at 6M (n=14, p≤0.003); Global Executive Composite and Emergent Metacognition at 12M (n=10, p=0.03). Visual Motor Integration (VMI-6) Copying (mean=90.3±13.8, p=0.0002) and VMI-6 Motor Coordination (mean=85.1 ±15.2 p=0.0002) fell below norms, but full scale IQ (Wechsler Scales) and Attention (Conners’ Continuous Performance Test) did not. survivors of PALF appear to show deficits in motor skills, EF, HRQOL, and evidence for worsening cognitive fatigue from 6M to 12M following PALF presentation.
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作者：
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DOI：
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