Parent reports of health-related quality of life and heart failure severity score independently predict outcome in children with dilated cardiomyopathy

Susanna L. Den Boer, Sara J. Baart, Marijke H. Van Der Meulen, Gabriëlle G. Van Iperen, Ad P. Backx, Arend D.Ten Harkel, Lukas A. Rammeloo, Gideon J. Du Marchie Sarvaas, Ronald B. Tanke, Willem A. Helbing, Elisabeth M. Utens, Michiel Dalinghaus*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background Dilated cardiomyopathy in children causes heart failure and has a poor prognosis. Health-related quality of life in this patient group is unknown. Moreover, results may provide detailed information of parents' sense of their child's functioning. We hypothesised that health-related quality of life, as rated by parents, and the paediatric heart failure score, as assessed by physicians, have both predictive value on outcome. Methods and results In this prospective study, health-related quality of life was assessed by parent reports: the Infant Toddler Quality of Life questionnaire (0-4 years) or Child Health Questionnaire-Parent Form 50 (4-18 years) at 3-6-month intervals. We included 90 children (median age 3.8 years, interquartile range (IQR) 0.9-12.3) whose parents completed 515 questionnaires. At the same visit, physicians completed the New York University Pediatric Heart Failure Index. Compared with Dutch normative data, quality of life was severely impaired at diagnosis (0-4 years: 7/10 subscales and 4-18 years: 8/11 subscales) and ≥1 year after diagnosis (3/10 and 6/11 subscales). Older children were more impaired (p<0.05). After a median follow-up of 3 years (IQR 2-4), 15 patients underwent transplantation. Using multivariable time-dependent Cox regression, physical functioning subscale and the Heart Failure Index were independently predictive of the risk of death and heart transplantation (hazard ratio 1.24 per 10% decrease of predicted, 95% confidence interval (CI) 1.06-1.47 and hazard ratio 1.38 per unit, 95% CI 1.19-1.61, respectively). Conclusion Physical impairment rated by parents and heart failure severity assessed by physicians independently predicted the risk of death or heart transplantation in children with dilated cardiomyopathy.

Original languageEnglish
Pages (from-to)1194-1202
Number of pages9
JournalCardiology in the Young
Volume27
Issue number6
DOIs
Publication statusPublished - 1 Aug 2017

Cite this

Den Boer, S. L., Baart, S. J., Van Der Meulen, M. H., Van Iperen, G. G., Backx, A. P., Harkel, A. D. T., ... Dalinghaus, M. (2017). Parent reports of health-related quality of life and heart failure severity score independently predict outcome in children with dilated cardiomyopathy. Cardiology in the Young, 27(6), 1194-1202. https://doi.org/10.1017/S1047951116002833