Patient-Reported Outcomes After Tetralogy of Fallot Repair

Abstract

<h3>Background</h3><p>Comprehensive assessment of <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/fallot-tetralogy" title="Learn more about tetralogy of Fallot from ScienceDirect's AI-generated Topic Pages">tetralogy of Fallot</a> (TOF) outcomes extends beyond morbidity and mortality to incorporate patient-reported outcomes (PROs), including quality of life (QOL) and health status (HS).</p><h3>Objectives</h3><p>This study explored PROs in adolescents and adults with TOF and delineated variables associated with PROs.</p><h3>Methods</h3><p>This was a cross-sectional observational study within a larger prospective registry of adolescents and adults with repaired TOF and moderate or greater <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/pulmonary-valve-insufficiency" title="Learn more about pulmonary regurgitation from ScienceDirect's AI-generated Topic Pages">pulmonary regurgitation</a> from North America, Europe, and Asia. Participants completed PROs, including a QOL linear analogue scale (QOL-LAS) and an HS <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/visual-analog-scale" title="Learn more about visual analogue scale from ScienceDirect's AI-generated Topic Pages">visual analogue scale</a> (HS-VAS). Scores were classified according to age cohorts: <18, 18 to 25, 26 to 40, and >40 years.</p><h3>Results</h3><p>The study included 607 patients (46.3% female; median age 28.5 years). Median QOL-LAS scores (0-100) were similar across age cohorts (85, 80, 80, 80; <em>P</em> = 0.056). Median HS-VAS scores (0-100) were lowest for the oldest cohort (77) compared with the 3 younger cohorts (85, 80, 80) (<em>P</em> = 0.004). With advancing age, there were increased reports of poor mobility (<em>P</em> < 0.001) and pain or discomfort (<em>P</em> = 0.004); problems in these dimensions were reported by 19.1% and 37.2% of patients aged >40 years, respectively. Of factors associated with superior PROs on multivariable regression modeling (ie, being White, being nonsyndromic, having employment, and having better <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/heart-left-ventricle-function" title="Learn more about left ventricular function from ScienceDirect's AI-generated Topic Pages">left ventricular function</a>; <em>P</em> < 0.05), asymptomatic status (functional class I) was the variable associated with the greatest number of QOL and HS measures (P < 0.001).</p><h3>Conclusions</h3><p>Strategies to improve TOF outcomes should consider PROs alongside conventional clinical variables. Factors associated with poorer PROs represent opportunities to intervene to improve the lives of patients with TOF.</p>