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Open Access 01-12-2021 | Heart Surgery | Research

ADHD symptomatology of children with congenital heart disease 10 years after cardiac surgery: the role of age at operation

Authors: Nikoletta R. Czobor, Zsófia Ocsovszky, György Roth, Szabolcs Takács, Márta Csabai, Edgár Székely, János Gál, Andrea Székely, Barna Konkolÿ Thege

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

The aim of the present study was to investigate the differences in ADHD symptomatology between healthy controls and children who underwent cardiac surgery at different ages.

Methods

Altogether, 133 children (54 patients with congenital heart disease undergoing first cardiac surgery under 3 years of age, 26 operated at the age of 3 or later, and 53 healthy controls) were examined. Patients completed the Youth Self Report (YSR), while their parents completed the Child Behaviour Checklist (CBCL) and the ADHD Rating Scale-IV.

Results

Children receiving surgery for the first time under the age of 3 years were more likely diagnosed with cyanotic type malformation and have undergone to a greater number of operations. However, ADHD symptoms of those treated surgically at or above 3 years of age were more severe than that of the control group or those who were treated surgically at a younger age. The control group and those treated surgically below the age of three did not differ across any of the ADHD symptom severity indicators.

Conclusions

The age at the time of cardiac surgery might be associated with later ADHD symptom severity – with lower age at operation associated with better outcomes. Further, adequately powered studies are needed to confirm these exploratory findings and investigate the moderators of this relationship.

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Enrollment was most significantly influenced by two factors, namely 1) likelihood of children showing up for check-up appointments (parents whose children are doing well often do not bring their children for check-ups a decade after surgery) and 2) match with the research staff’s hours of availability.

We estimate though that the likelihood of such selection bias is relatively low. The average operation-related annual mortality rate in the given cardiac center during the study period was 4.24% [37]. Even if assuming that all patients who died, had they survived, would have been part of the subgroup of clients operated under the age of 3 and all would have been characterized by a diagnosable severity level of ADHD symptomatology, that would increase the number of ADHD diagnoses in this study group from 3 (5.88%) to 5 (9.26%). Even in this case, the estimated ADHD prevalence rates in the subgroup operated above at or above 3 years of age remained higher (12–23%, depending on assessment tool, cf. Table 1).

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Title: ADHD symptomatology of children with congenital heart disease 10 years after cardiac surgery: the role of age at operation
Authors: Nikoletta R. Czobor
Zsófia Ocsovszky
György Roth
Szabolcs Takács
Márta Csabai
Edgár Székely
János Gál
Andrea Székely
Barna Konkolÿ Thege
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Heart Surgery
Heart Surgery
Pediatric Cardiac Surgery
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03324-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

ADHD symptomatology of children with congenital heart disease 10 years after cardiac surgery: the role of age at operation

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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