title: Functional health status of adults with tetralogy of Fallot: matched comparison with healthy siblings.
abstract: BACKGROUND
  Survival prospects for adults with repaired tetralogy of Fallot (TOF) are now excellent. Attention should therefore shift to assessing and improving functional health status and quality of life. We aimed to assess late functional health status of adults surviving TOF repair by matched comparison to their healthy siblings.
  
  
  METHODS
  All 1,693 TOF repairs performed at our institution between 1946 and 1990 were reviewed. A matched comparison was undertaken whereby presumed survivors and their healthy sibling were contacted and asked to complete the Ontario Health Survey 1990 and the 36-Item Short Form Health Survey (SF-36) questionnaire.
  
  
  RESULTS
  Both questionnaires were completed by 224 adult survivors and their sibling closest in age. Adults with repaired TOF had lower scores for self-perceived general health status (p < 0.001), were less likely to rate their health as good or excellent (p < 0.001), and had lower SF-36 scores for physical functioning and general health (p = 0.001) than their siblings. However, patients reported similar satisfaction with their lives, similar levels of social participation and support, and were as likely to be in long-term partnerships. Worse physical and mental health scores were associated with older age at surgery and at time of questionnaire completion and recent requirement for noncardiac medication.
  
  
  CONCLUSIONS
  Although reporting lower functional health status then their siblings, quality of life and life satisfaction for adults who underwent surgery for TOF during childhood is comparable to that of their siblings without heart defects. Follow-up of younger adults is required to understand current health outcomes attributable to improvements in the management of TOF.
authors.affiliation: Division of Cardiology, Department of Pediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Rachel
authors.initials: R
authors.lastname: Knowles
authors.forename: Gruschen
authors.initials: G
authors.lastname: Veldtman
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Hickey
authors.forename: Timothy
authors.initials: T
authors.lastname: Bradley
authors.forename: Aungkana
authors.initials: A
authors.lastname: Gengsakul
authors.forename: Gary D
authors.initials: GD
authors.lastname: Webb
authors.forename: William G
authors.initials: WG
authors.lastname: Williams
authors.forename: Brian W
authors.initials: BW
authors.lastname: McCrindle
mesh_terms: D000293:Adolescent; D000328:Adult; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D035781:Siblings; D013771:Tetralogy of Fallot / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery