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Long-term Quality of Life in Neonatal Surgical Disease. Ann Surg 2018 09;268(3):497-505

Date

07/12/2018

Pubmed ID

29994930

DOI

10.1097/SLA.0000000000002918

Scopus ID

2-s2.0-85056173042   14 Citations

Abstract

OBJECTIVE: This prospective observational study was designed to assess Pediatric Quality of Life (PedsQL) after surgical treatment for congenital diaphragmatic hernia (CDH), esophageal atresia/tracheoesophageal fistula (EA/TEF), Hirschsprung disease (HD), gastroschisis (GAS), omphalocele (OMP), and necrotizing enterocolitis (NEC).

SUMMARY OF BACKGROUND DATA: Improvements in neonatal and surgical care have led to increased survival for many newborn conditions. Quality of life in these patients is seldom explored in a longitudinal manner. We hypothesized that age-adjusted physical and psychosocial scores would improve over time, but with diagnosis-dependent variation.

METHODS: Data were collected from 241 patients (CDH = 52; EA/TEF = 62; HD = 46; GAS = 32; OMP = 26; NEC = 23) in an institutional Clinical Outcomes Registry (COR) from 2012 to 2017. Aggregate physical, psychosocial, and overall PedsQL scores were determined for each diagnosis. Spline regression models were created to model scores as a function of age.

RESULTS: Physical scores trended up for all diagnoses except CDH and NEC beyond age 10. Psychosocial scores trended up for all diagnoses except NEC and EA/TEF beyond age 10. Beyond age 12, CDH, GAS, and HD patients had overall scores within the normal range, while NEC, OMP, and EA/TEF patients had scores similar to children with chronic medical illness.

CONCLUSION: Variation exists in long-term PedsQL scores after neonatal surgery for selected, complex disease. Beyond age 12, quality of life is significantly impaired in NEC, moderately impaired in OMP and EA/TEF, and within normal range for CDH, HD, and GAS patients at the population level. These data are relevant to prenatal and perioperative discussions with patients and families.

Author List

Amin R, Knezevich M, Lingongo M, Szabo A, Yin Z, Oldham KT, Calkins CM, Sato TT, Arca MJ

Authors

Casey Matthew Calkins MD Professor in the Surgery department at Medical College of Wisconsin
Keith T. Oldham MD Professor in the Surgery department at Medical College of Wisconsin
Thomas T. Sato MD Professor in the Surgery department at Medical College of Wisconsin
Aniko Szabo PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Enterocolitis, Necrotizing
Esophageal Atresia
Female
Gastroschisis
Hernia, Umbilical
Hernias, Diaphragmatic, Congenital
Hirschsprung Disease
Humans
Infant, Newborn
Infant, Newborn, Diseases
Male
Prospective Studies
Quality of Life
Registries
Tracheoesophageal Fistula
Wisconsin
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a