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Abstract O-07: NEURODEVELOPMENTAL OUTCOMES IN PRE-SCHOOL CHILDREN WITH HEART DISEASE IN LONDON

Hoskote, A.1; Banks, V.2; Kakat, S.1; Ridout, D.3; Lakhanpaul, M.4; Pagel, C.5; Franklin, R.6; Brimmell, R.7; Witter, T.7; Tibby, S.7; Anderson, D.7; Tsang, V.8; Brown, K.1; Wray, J.9

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 6
doi: 10.1097/01.pcc.0000537349.31065.9a
Oral Abstracts
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1Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiac Intensive Care, London, United Kingdom

2Great Ormond Street Hospital for Children NHS Foundation Trust, Senior analyst Cardiothoracic Services, London, United Kingdom

3UCL Great Ormond Street Institute of Child Health, Population- Policy and Practice Programme, London, United Kingdom

4UCL Great Ormond Street Institute of Child Health, Community Child Health, London, United Kingdom

5University College London, Clinical Operational Research Unit, London, United Kingdom

6Royal Brompton and Harefield NHS Foundation Trust, Paediatric Cardiology Department, London, United Kingdom

7Evelina London Children’s Hospital, Department Paediatric Cardiology and Cardiac Surgery, London, United Kingdom

8Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiothoracic Surgery, London, United Kingdom

9Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiothoracic Unit, London, United Kingdom

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Aims & Objectives:

To assess the neurodevelopmental profile of pre-school children with heart disease (HD) in 3 London-based cardiac centres with Mullen Scales of Early Learning (MSEL), and to study the performance of the parental Ages and Stages questionnaire (ASQ-3).

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Methods

Children <5 years with HD recruited from January 2014-July 2015 underwent MSEL testing, and parents completed ASQ-3.

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Results

Of 971 children (median (IQR) age: 11.3 (5.0, 30.8) months), 497 (51.2%) were male, and 577 (59.4%) had ≥1 heart operations. MSEL Cognitive: 762 (78.5%) scored within/above normal range, 119 (12.3%) scored 1–2 SD, and 90 (9.3%) scored >2 SD below the normative mean. MSEL Motor: Of 753 children <33 months, 540 (71.7%) scored within normal range, 124 (16.5%) scored 1–2 SD and 89 (11.8%) scored >2 SD below the normative mean. ASQ-3: Of 826 completed questionnaires, 232 (28.1%) were normal, 209 (25.3%) were borderline and 385 (46.6%) were abnormal. Multivariate analysis for factors associated with low scores: age - 35–60 weeks odds ratio (95% Confidence Intervals) 22.5 (6.5, 77.3) p<0.001, 15 months to 2.9 years 21.7 (6.3, 74.2) p<0.001, surgery 1.59 (1.03, 2.45) p=0.03, known factor for developmental delay 11.3 (5.33, 24.06) and syndrome 11.97 (7.6, 18.8) p<0.001. Comparison between ASQ and MSEL is shown in the graph. Red/amber ASQ had sensitivity of 99% against red/amber MSEL cognitive and/or motor with specificity 32%, high negative predictive value (99%) and low positive predictive value (20%).

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Conclusions

The ASQ-3 identified a higher proportion of children as abnormal than the MSEL. Children with HD need close monitoring of neurodevelopment.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies