Neuropsychological outcomes in CHD beyond childhood: a meta-analysis.

Abstract:

BACKGROUND:Risk for neurodevelopmental delay in infants and children with CHD is well established, but longer-term outcomes are equivocal. A meta-analysis was conducted to establish whether cognitive deficits remain beyond childhood - into teenage and young adult years. Methods and results A total of 18 unique samples, involving adolescents, teenagers, and adults with CHD significant enough to require invasive intervention, and sourced through searches of Web of Science, MEDLINE, CINAHL Plus, and PsychInfo, met the inclusion criteria. These included the use of standardised neuropsychology tests across 10 domains of cognitive functioning and the reporting of effect size differences with controls. Reports of patients with chromosomal or genetic abnormalities were excluded. Pooled effect sizes suggested no significant differences between CHD samples and controls in terms of general intellectual ability and verbal reasoning. However, small-medium effects sizes were noted (0.33-0.44) and were statistically significant within the domains of non-verbal reasoning, processing speed, attention, auditory-verbal memory, psychomotor abilities, numeracy, and literacy with executive functioning also emerging as significant when one study outlier was excluded. We also included quality assurance statistics including Cochran's Q, T, and I2 statistics, leave-one-out analyses, and assessment of publication bias. These often suggested study variability, possibly related to the heterogeneity of diagnostic groups included, and different tests used to measure the same construct. CONCLUSIONS:Heterogeneity indicated that moderators affect cognitive outcomes in CHD. Nevertheless, deficits across cognitive domains were discerned, which are likely to have functional impact and which should inform practice with this clinical population.

journal_name

Cardiol Young

journal_title

Cardiology in the young

authors

Mills R,McCusker CG,Tennyson C,Hanna D

doi

10.1017/S104795111700230X

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

421-431

issue

3

eissn

1047-9511

issn

1467-1107

pii

S104795111700230X

journal_volume

28

pub_type

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