title: Medical factors that predict quality of life for young adults with congenital heart disease: What matters most?
abstract: BACKGROUND
  Identify demographic and medical status indicators that account for variability in physical and emotional health-related quality of life (QoL) among young adults with congenital heart disease (CHD) as compared to traditional lesion severity categories.
  
  
  METHODS
  Cross-sectional study of 218 young adult survivors of CHD (mean=25.7, SD=7.1 years). Participants were recruited from pediatric and adult CHD clinics at a pediatric and an adult hospital. Stepwise linear regression examined the unique contribution of demographic (age; sex; estimated income) and medical status indicators (comorbid conditions; treatment modality; ventricular function/functional capacity) on QoL compared to traditional lesion severity categories (simple; moderate; complex).
  
  
  RESULTS
  Lesion severity category accounted for a small portion of the variance in physical QoL (3%), but was not associated with emotional QoL. Lesion severity did not significantly contribute to the variability in physical QoL once other variables were entered. Having an estimated income of ≤$30,000, taking more than one cardiac-related medication, and having a New York Heart Association (NYHA) functional class designation>I was associated with poorer physical QoL and explained 23% of the variability. NYHA class was the only variable that explained a unique proportion of variance (7%) in emotional QoL, and having a NYHA class designation>I was associated with greater risk for poorer emotional functioning.
  
  
  CONCLUSIONS
  Findings suggested that several indicators readily available to treatment teams may provide important information about the risk for poor patient-reported outcomes of physical and emotional QoL among CHD survivors.
authors.affiliation: Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatrics, The Ohio State University, Columbus, OH, United States. Electronic address: jamie.jackson2@nationwidechildrens.org.
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Jackson
authors.affiliation: College of Medicine, The Ohio State University, Columbus, OH, United States.
authors.forename: Lauren
authors.initials: L
authors.lastname: Hassen
authors.affiliation: Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, United States.
authors.forename: Gina M
authors.initials: GM
authors.lastname: Gerardo
authors.affiliation: Center for Biobehavioral Health, Nationwide Children's Hospital, Columbus, OH, United States; Department of Pediatrics, The Ohio State University, Columbus, OH, United States.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Vannatta
authors.affiliation: Columbus Ohio Adult Congenital Heart Disease Program, Heart Center, Nationwide Children's Hospital, Columbus, OH, United States; Departments of Internal Medicine and Pediatrics, The Ohio State University, Columbus, OH, United States.
authors.forename: Curt J
authors.initials: CJ
authors.lastname: Daniels
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000523:psychology; D006801:Humans; D008297:Male; D009017:Morbidity / Q000639:trends; D009820:Ohio / Q000453:epidemiology; D011379:Prognosis; D011788:Quality of Life; D012189:Retrospective Studies; D055815:Young Adult
keywords: Congenital heart defects; Quality of life