Zhongguo gonggong weisheng (Jun 2022)
Impact of delayed diagnosis time on post-surgery recovery in 0 – 18 years old congenital heart disease patients in 8 western provinces of China: a comparative analysis
Abstract
ObjectiveTo explore the association of delayed diagnosis time with post-surgery recovery in children with congenital heart disease (CHD) for providing evidences to effective early screening and treatment of CHD.MethodsFrom January 2017 to December 2020, a CHD screening program was conducted among 3 015 470 students from 7 783 schools in 8 provincial-level regions in western China and totally 3 805 diagnosed CHD patients were surgically treated at Fuwai Yunnan Cardiovascular Hospital and followed up for post-treatment management. Medical records and information on physical-psychological-social adaptation of the CHD patients aged 0 – 18 years were collected and analyzed to assess the correlation between delayed diagnosis time and post-surgery recovery in the child patients.ResultsOf the 2 879 child patients included in the analysis, 66.3% (1 908) had delayed diagnosis of CHD and 23.0% (663), 21.4% (615), and 21.9% (630) had delayed diagnosis time of 0.03 – 3 years, 3.01 – 7.5 years, and longer than 7.5 years, respectively. Among the child patients with delayed diagnosis time of 0.03 – 3 years, 19.7% had developmental retardation and 28.0% had difficulty in group living; of the child patients with the delayed diagnosed time longer than 7.5 years, 17.4% were assessed being prone to have negative emotion. After adjusting for gender, age, ethnics, type of CHD, and family structure, the results of multivariate logistic regression analysis demonstrated that compared to those with the delayed diagnosis time of longer than 7.5 years, the child patients with shorter delayed diagnosis time were at a decreased the risk of post-surgery negative emotion with the odds ratio (OR) of 0.685 (95% confidence interval [95% CI]: 0.499 – 0.940) for those with the time of 0.03 – 3 years and the OR of 0.630 (95% CI: 0.450 – 0.882) for those with the time of 3.01 – 7.5 years; while, compared to those with the delayed diagnosis time of 0.03 – 3 years, the child patients being timely diagnosed and the patients with the delayed diagnosis time longer than 7.5 years were at a decreased risk of having difficulty in group living, with the OR of 0.717 (95% CI: 0.563 – 0.914) and OR of 0.685 (95% CI: 0.528 – 0.888), respectively. ConclusionAmong child patients having surgery treatment, the delayed time of CHD diagnosis can influence post-surgery recovery; the delayed diagnosis time of 7.5 years is associated with the incidence of post-surgery negative emotion and that of 0.03 – 3 years is related to having difficulty in group living after surgery treatment.
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