Neurodevelopmental outcome after congenital heart surgery: Results from an institutional registry
Neurodevelopmental outcome after congenital heart surgery: Results from an institutional registry
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DOI：
10.1161/01.cir.0000032915.33237.72
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发表时间：
2002-09-24
期刊：
影响因子：
37.8
通讯作者：
Jonas, RA
中科院分区：
文献类型：
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作者：
Forbess, JM;Visconti, KJ;Jonas, RA
目的-危重先天性心脏病(CHD)患儿存活率的增加引起了人们对这些病变的神经发育后遗症的兴趣。本研究是一项旨在研究先天性心脏病修复术或姑息术后5岁儿童神经发育的机构努力的一部分。方法：我们在1998-2001年间对243名儿童进行了一系列的神经心理测试。结果总体上，样本的平均智商(FSIQ)、言语智商(VIQ)和操作智商(PIQ)在正常范围内(分别为96.8+/-15.9、97.8+/-14.6和96.3+/-17.1)。评估了解剖学、人口学和围手术期因素对神经发育的影响。多元回归分析显示，低社会经济地位和诊断为瓣膜面部综合征患者的FSIQ较低(P=0.001)。单脑室诊断(P=0.06)、术后ICU住院时间长(P=0.08)和累积低温停循环时间(P=0.09)是FSIQ降低的预测因素。结论：CHD患儿的智力总体上处于平均水平。较低的SES和VCFS与较低的智商分数相关。在单室患者、两室患者在ICU后住院时间较长、以及接受HCA时间较长的患者中，观察到预后较差的趋势。
Objective-Increased survival in children with critical congenital heart disease (CHD) has raised interest in the neurodevelopmental sequelae of these lesions. This investigation is part of an institutional effort to examine the neurodevelopment of 5-year-old children following repair or palliation of CHD.Methods-We performed a battery of neuropsychological tests on a sample of 243 children between 1998 and 2001.Results-In the sample as a whole, mean full-scale (FSIQ), verbal (VIQ), and performance (PIQ) IQ scores were in the normal range (96.8+/-15.9, 97.8+/-14.6, and 96.3+/-17.1, respectively). Anatomic, demographic, and perioperative factors were assessed for impact on neurodevelopment. In multiple regression analysis, lower socioeconomic status (SES) and the diagnosis of velocardiofacial syndrome (VCFS) predicted a lower FSIQ (P=0.01, and P=0.001, respectively). A single ventricle diagnosis (P=0.06), longer postoperative ICU stay (P=0.08), and cumulative duration of hypothermic circulatory arrest (HCA) (P=0.09) approached significance as predictors of lower FSIQ.Conclusion-Children with CHD, on the whole, appear to be performing within the average range in terms of intellectual abilities. Lower SES and VCFS are associated with lower IQ scores. Trends toward worse outcomes were observed in single ventricle patients, biventricular patients with longer postrepair ICU stays, and patients subjected to longer periods of HCA.