Choices Doctors Would Make If Their Infant Had Hypoplastic Left Heart Syndrome: Comparison of Survey Data From 1999 and 2007
Choices Doctors Would Make If Their Infant Had Hypoplastic Left Heart Syndrome: Comparison of Survey Data From 1999 and 2007
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如果婴儿患有左心发育不良综合征，医生会做出的选择：1999 年和 2007 年调查数据的比较
作者：
A. Kon;M. Prša;C. Rohlicek
数据表明，尽管左心发育不良综合征（HLHS）婴儿的手术结局有所改善，但过去二十年来，父母在没有延长生命干预的情况下选择手术或姑息治疗的决定几乎没有变化。数据还表明，医生对自己的婴儿被诊断患有HLHS时他们会做出的选择的预测与他们对手术结果的预测无关。虽然以前的研究比较了手术和姑息治疗的比率，但没有延长生命的干预措施，没有研究评估医生态度的变化。目前的研究使用描述性和定量统计来比较1999年和2007年进行的研究中美国儿科心脏病专家和先天性心脏病外科医生的反应。这些医生被问到他们认为他们会为自己受影响的婴儿做出什么选择。对1999年和2007年的答复进行比较，结果显示心脏病专家的答复没有差异：1999年（44%手术，17%姑息治疗，40%不确定）与2007年（45%手术，20%姑息治疗，35%不确定）。在外科医生中，有一个非统计学显著的趋势远离选择手术：1999年（77%手术，5%姑息治疗，18%不确定）与2007年（56%手术，8%姑息治疗，36%不确定）。总之，这些分析表明，尽管改善了手术结果，医生不太可能预测他们会选择手术治疗他们自己假设的HLHS婴儿。需要进一步的研究来确定哪些因素影响HLHS婴儿护理的选择。
Data suggest that despite improved surgical outcomes for infants with hypoplastic left heart syndrome (HLHS), the past two decades have seen little change in parents’ decisions whether to choose surgery or palliative treatment without life-prolonging intervention. Data also suggest that doctors’ predictions of the choices they would make if their own infant were diagnosed with HLHS do not correlate with their predictions of surgical outcomes. Although previous studies have compared rates of surgery and palliative treatment without life-prolonging intervention over time, no studies have assessed changes in doctors’ attitudes. The current study used descriptive and quantitative statistics to compare responses from American pediatric cardiologists and congenital cardiac surgeons from studies conducted in 1999 and 2007. These doctors were asked what choice they believe they would make for their own affected infant. Comparison of responses from 1999 and 2007 showed no difference in the responses of cardiologists: 1999 (44 % surgery, 17 % palliative treatment, 40 % uncertain) versus 2007 (45 % surgery, 20 % palliative treatment, 35 % uncertain). Among surgeons, there was a non-statistically significant trend away from choosing surgery: 1999 (77 % surgery, 5 % palliative treatment, 18 % uncertain) versus 2007 (56 % surgery, 8 % palliative treatment, 36 % uncertain). In conclusion, these analyses suggest that despite improving surgical outcomes, doctors are no more likely to predict that they would choose surgery for their own hypothetical infant with HLHS. Further research is needed to determine what factors influence choice making in the care of infants with HLHS.