Quality of life of children with neurological impairment who receive a fundoplication for gastroesophageal reflux disease

Abstract

BACKGROUNDChildren with neurological impairment (NI) commonly have gastroesophageal reflux disease (GERD) treated with a fundoplication. The impact of this procedure on quality of life is poorly understood.OBJECTIVESTo examine the quality of life of children with NI who have received a fundoplication for GERD and of their caregivers.METHODSThe study was a prospective cohort study of children with NI and GERD who underwent a fundoplication at a children's hospital between January 1, 2005, and July 7, 2006. Quality of life of the children was assessed with the Child Health Questionnaire (CHQ) and of the caregivers with the Short‐Form Health Survey Status (SF‐36) and Parenting Stress Index (PSI), both at baseline and 1 month after fundoplication. Functional status was assessed using the WeeFIM®. Repeated‐measures analyses were performed.RESULTSForty‐four of the 63 parents (70%) were enrolled. The median WeeFIM® score was 31.2 versus the age‐normal score of 83 (P = .001). Compared with the baseline scores, mean CHQ scores improved over 1 month in the domains of bodily pain (32.8 vs. 47.5, P = .01), role limitations–physical (30.6 vs. 56.6, P = .01), mental health (62.7 vs. 70.6, P = .01), family limitation of activities (43.3 vs. 55.1, P = .03), and parental time (43.0 vs. 55.3, P = .03). The parental SF‐36 domain of vitality improved from baseline over 1 month (41.3 vs. 48.2, P = .001), but there were no changes from baseline in Parenting Stress scores.CONCLUSIONSParents reported that the quality of life of children with NI who receive a fundoplication for GERD was improved from baseline in several domains 1 month after surgery. The quality of life and stress of caregivers did not improve in nearly all domains, at least in the short term. Journal of Hospital Medicine 2007;2:165–173. © 2007 Society of Hospital Medicine.

Impact of laparoscopic anterior 270° fundoplication on the quality of life and symptoms profile of neurodevelopmentally delayed versus neurologically unimpaired children and their parents

“…It is known that for dystrophic and neurologically impaired children and their parents, lower preoperative functional and QoL scores throughout all dimensions [25] may correspond with a poorer functional outcome [2,4] and a higher recurrence rate [19] than for normal children [18]. On the other hand, it is suggested that otherwise healthy GERD patients benefit less from the operation and can therefore be managed medically [2].…”

Impact of Fundoplication Versus Gastrojejunal Feeding Tubes on Mortality and in Preventing Aspiration Pneumonia in Young Children With Neurologic Impairment Who Have Gastroesophageal Reflux Disease

“…We enrolled patients meeting the following criteria: (1) date of birth between January 1, 1997, and December 31, 2005; (2) having a previously published International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for neurologic impairment, 12,20 with the following additions, demyelinating central ner (internal charge code) placed between January 1, 1997, and December 31, 2005, at PCMC (see Fig 1). GJTs were image-guided feeding tube placements after a previously placed gastrostomy feeding tube.…”

Health Care Use During Transfer to Adult Care Among Youth With Chronic Conditions

“…Chronic conditions were sorted hierarchically into mutually exclusive condition categories. At the top of the hierarchy was neurologic impairment (NI), defined as diagnoses consistent with static or progressive neurologic, genetic, or other diseases that typically result in functional and/or intellectual impairment, 16 followed by the following chronic conditions: congenital heart disease (CHD), cystic fibrosis (CF), systemic lupus erythematosus (SLE), sickle cell disease (SCD), inflammatory bowel disease (IBD), type 1 diabetes mellitus (DM), and asthma. Last, we explored 3 chronic mental health conditions: eating disorders, schizophrenia and related psychotic disorders (SZ), and mood and affective disorders (MA).…”