title: Quality of life and cognitive function in Fontan patients, a population-based study.
abstract: BACKGROUND
  After the Fontan procedure patients are at risk for reduced quality of life (QoL) and cognitive function. We aimed to assess these important factors in Danish Fontan patients and to compare the results with a group of healthy controls.
  
  
  METHODS
  All Fontan patients living in Denmark were identified and invited to participate. QoL was evaluated using the Pediatric Quality of Life Inventory (PedsQL) version 4.0 generic core module in patients <16 years and the Short Form 36 questionnaire (SF-36) in patients ≥16 years. Cognitive function was evaluated in all patients ≥6 years using the Quick Test of Cognitive Speed. To evaluate if QoL correlated with exercise capacity, patients performed a symptom-limited bicycle test.
  
  
  RESULTS
  158 of 179 eligible patients (88%) consented to participate. Median age was 13.9 years (IQR: 10.2-19.3). PedsQL scores increased with age but were significantly lower among patients than among controls. SF-36 physical scores were significantly lower in patients compared to controls while psychosocial scores were similar. Cognitive speed was significantly reduced in patients at all ages compared to controls. No significant difference in PedsQL-/SF-36 scores or cognitive speed was found between hypoplastic left heart syndrome (HLHS) and non-HLHS Fontan patient. PedsQL-/SF-36 scores in patients ≥10 years correlated significantly to cognitive speed but not to peak exercise capacity.
  
  
  CONCLUSIONS
  QoL is reduced in Fontan children compared to their healthy counterparts whereas in patients ≥16 years only physical, but not psychosocial QoL is reduced. Cognitive speed was significantly lower in patients at all ages compared to controls.
authors: Department of Cardiology, Rigshospitalet, Copenhagen, Denmark. Electronic address: lars.idorn@rh.regionh.dk.
authors: Lars
authors: L
authors: Idorn
authors: Annette S
authors: AS
authors: Jensen
authors: Klaus
authors: K
authors: Juul
authors: Dorthe
authors: D
authors: Overgaard
authors: Niels P
authors: NP
authors: Nielsen
authors: Keld
authors: K
authors: Sørensen
authors: Jesper I
authors: JI
authors: Reimers
authors: Lars
authors: L
authors: Søndergaard
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D018729:Fontan Procedure / Q000523:psychology*; D006801:Humans; D008297:Male; D011159:Population Surveillance / Q000379:methods*; D011788:Quality of Life / Q000523:psychology*
keywords: Cognitive function; Congenital heart disease; Fontan patients; Quality of life