Congenital heart surgery may affect long-term social outcomes

1. Patients who underwent congenital heart surgery (CHS) had lower rates of advanced educational levels and employment and higher rates of retirement when compared to those who did not have CHS.

2. Patients who underwent CHS were less likely to be married and have children when compared to those who did not have CHS.

Evidence Rating Level: 2 (Good)

Study Rundown: Only a few studies have aimed to understand the long-term socioeconomic impact of CHS, and even fewer have used objective data to do so. Study researchers obtained demographic, socioeconomic, and other population-based information from various registries and databases in Finland. Findings suggest that surgical patients had lower rates of undergraduate or graduate education but at least equal rates of high school or vocational education as non-surgical controls. Additionally, surgical patients had lower rates of employment, greater rates of retirement, lower rates of being married, and were less likely to have had children when compared to non-surgical controls. Of note, the effects of parental socioeconomic background and comorbidities on social outcomes were not considered. However, the use of registries and databases allows for an objective understanding about how CHS may affect social outcomes and helps avoid participant bias that may result from the use of questionnaires in assessment of social outcomes. This study may help physicians prevent or mitigate such social challenges in CHS patients and families with closer screening and monitoring during follow-up visits.

Click to read the study, published today in Pediatrics

Relevant Reading: Long-Term Results of Pediatric Cardiac Surgery in Finland: Education, Employment, Marital Status, and Parenthood

In-Depth [retrospective cohort study]: The ProCardio version 8 research registry, the Finnish Population Registry, and Statistics Finland database were used to gather surgical and demographic data, along with other statistical information on the Finnish population. Patients ≥ 18 years of age at the end of follow-up and who had CHS from 1953 to 2009 were included in the study along with control subjects matched by age, sex, and hospital district. Study results indicated that female patients who had CHS had lower rates of undergraduate education (RR 0.8 with 95% CI 0.99-1.06) and graduate education (RR 0.7 with 95% CI 0.64-0.79) but at least equal levels of high school or vocation education as compared to control subjects, whereas male patients with CHS had lower rates of all education levels compared to controls. Female and male patients who had CHS had lower employment rates (RR 0.8 with 95% 0.81-0.86 and RR 0.8 with 95% CI 0.80-0.86, respectively) and greater retirement (RR 2.1 with 95% CI 1.99-2.32 and RR 3.1 with 95% CI 2.85-3.47, respectively) when compared to controls. Finally, both female and male patients who had CHS were less likely to be married (RR 0.9 with 95% CI 0.84-1.02 and RR 0.9 with 95% CI 0.83-0.93, respectively) and have children (RR 0.9 with 95% CI 0.89-0.93 and RR 0.9 with 95% CI 0.88-0.93, respectively) compared to controls.

Image: PD

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