131. Longitudinal Assessment of Health-Related Quality of Life in Adults with Congenital Heart Disease Patients Undergoing Cardiac Surgery: A Novel Approach Using Automated EMR Follow-Up
Presented During: Congenital Rapid Fire Orals
Cleveland Clinic Children's Hospital
Cleveland Heights, OH
United States - Contact Me
Dr. Potz is a currently a congenital cardiac surgery fellow at Cleveland Clinic. Prior to that she completed her cardiothoracic surgery training at the Massachusetts General Hospital and her general surgery training at Brown University. During her general surgery training, Dr. Potz spent three years in the cardiothoracic surgery lab of Dr. Frank W. Sellke working on the discovery of new medical therapies for coronary artery disease using a pig model of chronic myocardial ischemia in the setting of metabolic syndrome that translates to patients with CAD and their associated co-morbidities.
Sunday, April 28, 2024: 9:37 AM - 9:44 AM
7 Minutes
Metro Toronto Convention Center
Room: Room 716
Description
Objective:
Patients with adult congenital heart disease (ACHD) require life-long medical treatment. Longitudinal follow-up of this cohort is challenged by fragmented care paradigms and impaired transition from pediatric to adult care. This complex healthcare landscape inevitably influences the equilibrium of patients' perceived health-related quality of life (HR-QoL). Our center developed a novel electronic medical record (EMR)--based follow-up platform to assess HR-QoL among ACHD patients undergoing cardiac surgery. This study reports the results of this initiative among a complex cohort at our center.
Method:
Between January 2022- September 2023, we enrolled 104 patients (mean age 52±14) who underwent congenital heart surgery at our center and responded to HR-QOL questionnaires. Our comprehensive 23-element questionnaire included generic PROMIS 10 physical and mental scores and cardiac-specific MacNew social scores. Automated EMR assessments were delivered: 7 days preoperatively and postoperatively at 1,3,6, 12 months. A PROMIS 10 score exceeding 50 indicated superior self-reported physical and mental health compared to a matched age and sex U.S. population. MacNew social score above 5 signified enhanced social health compared to peers with cardiac disease. Multivariable linear regression models assessed relationships between patient characteristics, clinical variables, and HR-QOL outcomes.
Results:
Our cohort included 52 (50%) females, 69 married individuals (67%), and 40 patients who had undergone aortic valve interventions (41.6%). Male gender was a predictor of higher PROMIS 10 physical (P=0.04) and mental scores (P=0.0197) (Figure 1A, B) Over time, all PROMIS 10 mental and physical scores and MacNew social scores increased, from 1 month postoperatively to 12 months postoperatively (43± 10, 42±7, 4.4 ±1.1 versus 48±10,49± 12, 5.5 ±1.4; respectively). Notably, MacNew social score demonstrated significant improvements at 3 months (P =0.01), 6 months (P=0.003), and 12 months (P=0.001) ( (Figure 1C).
Conclusion:
Our innovative time series tool for assessing HR-QoL in ACHD patients demonstrates improved patient-perceived outcomes across mental, physical, and social domains, which continues over the first postoperative year. Social and mental domain gains outpaced perceived physical domain gains. Patient factors, including gender disparities contributing to HR-QoL differences, require further study to develop optimized treatment pathways
Authors
Brittany Potz (1), Miza Salim Hammoud (2), Justin Robinson (3), Matthew Thompson (4), Carla Duvall (1), Tara Karamlou (1)
Institutions
(1) Cleveland Clinic, Cleveland, OH, (2) Department of Pediatric Cardiac Surgery, Cleveland Clinic, Cleveland, OH, (3) N/A, N/A, (4) Cleveland Clinic, Lakewood, OH
Patients with adult congenital heart disease (ACHD) require life-long medical treatment. Longitudinal follow-up of this cohort is challenged by fragmented care paradigms and impaired transition from pediatric to adult care. This complex healthcare landscape inevitably influences the equilibrium of patients' perceived health-related quality of life (HR-QoL). Our center developed a novel electronic medical record (EMR)--based follow-up platform to assess HR-QoL among ACHD patients undergoing cardiac surgery. This study reports the results of this initiative among a complex cohort at our center.
Method:
Between January 2022- September 2023, we enrolled 104 patients (mean age 52±14) who underwent congenital heart surgery at our center and responded to HR-QOL questionnaires. Our comprehensive 23-element questionnaire included generic PROMIS 10 physical and mental scores and cardiac-specific MacNew social scores. Automated EMR assessments were delivered: 7 days preoperatively and postoperatively at 1,3,6, 12 months. A PROMIS 10 score exceeding 50 indicated superior self-reported physical and mental health compared to a matched age and sex U.S. population. MacNew social score above 5 signified enhanced social health compared to peers with cardiac disease. Multivariable linear regression models assessed relationships between patient characteristics, clinical variables, and HR-QOL outcomes.
Results:
Our cohort included 52 (50%) females, 69 married individuals (67%), and 40 patients who had undergone aortic valve interventions (41.6%). Male gender was a predictor of higher PROMIS 10 physical (P=0.04) and mental scores (P=0.0197) (Figure 1A, B) Over time, all PROMIS 10 mental and physical scores and MacNew social scores increased, from 1 month postoperatively to 12 months postoperatively (43± 10, 42±7, 4.4 ±1.1 versus 48±10,49± 12, 5.5 ±1.4; respectively). Notably, MacNew social score demonstrated significant improvements at 3 months (P =0.01), 6 months (P=0.003), and 12 months (P=0.001) ( (Figure 1C).
Conclusion:
Our innovative time series tool for assessing HR-QoL in ACHD patients demonstrates improved patient-perceived outcomes across mental, physical, and social domains, which continues over the first postoperative year. Social and mental domain gains outpaced perceived physical domain gains. Patient factors, including gender disparities contributing to HR-QoL differences, require further study to develop optimized treatment pathways
Authors
Brittany Potz (1), Miza Salim Hammoud (2), Justin Robinson (3), Matthew Thompson (4), Carla Duvall (1), Tara Karamlou (1)
Institutions
(1) Cleveland Clinic, Cleveland, OH, (2) Department of Pediatric Cardiac Surgery, Cleveland Clinic, Cleveland, OH, (3) N/A, N/A, (4) Cleveland Clinic, Lakewood, OH
Presentation Duration
You will have a 4 minute presentation followed by 3 minutes of discussion from the audience. All presenters must adhere to the presentation and discussion times provided. The AATS will begin to play music once your speaking time is exceeded.
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Women in Thoracic Surgery (WTS) Presentation