Health Related Quality of Life and Neurocognitive Outcomes in the First Year after Pediatric Acute Liver Failure. Academic Article uri icon

abstract

  • OBJECTIVE: To determine health-related quality of life (HRQoL) and neurocognitive impairment in survivors of pediatric acute liver failure (PALF). STUDY DESIGN: A longitudinal prospective study was conducted. At 6 and 12 months after PALF presentation, surveys of HRQoL were completed for 2- to 19-year-olds and executive functioning for ages 2-16 years. At 12 months, patients 3-16 years of age completed neurocognitive testing. HRQoL scores were compared with a healthy, matched sample. Neurocognitive scores were compared with norms; executive functioning scores were examined categorically. RESULTS: A total of 52 parent-report HRQoL surveys were completed at 6 months, 48 at 12 months; 25 patients completed neurocognitive testing. The median age at 6 months was 7.9 years (range 3.5-15.0), and final diagnosis was indeterminate for 46.2% (n=24). Self and parent-report on Pediatric Quality of Life Inventory Generic and Multidimensional Fatigue scales fell below the healthy sample at 6 months and 12 months (almost all P<.001). Children reported lower mean scores on cognitive fatigue at 12 months (60.9122.99) compared with 6months (73.6127.49, P=.006) . The distribution of Behavior Rating Inventory of Executive Function scores was shifted downward on parent-report (preschool) for all indices at 6 months (n=14, P.003); Global Executive Composite and Emergent Metacognition at 12 months (n=10, P=.03). Visual Motor Integration (VMI-6) Copying (mean=90.313.8, P=.0002) and VMI-6 Motor Coordination (mean=85.115.2 P=.0002) fell below norms, but full scale IQ (Wechsler Scales) and Attention (Conners' Continuous Performance Test) did not. CONCLUSIONS: Survivors of PALF appear to show deficits in motor skills, executive functioning, HRQoL, and evidence for worsening cognitive fatigue from 6 to 12 months following PALF presentation.

published proceedings

  • J Pediatr

altmetric score

  • 23.75

author list (cited authors)

  • Sorensen, L. G., Neighbors, K., Hardison, R. M., Loomes, K. M., Varni, J. W., Ng, V. L., ... Pediatric Acute Liver Failure Study Group.

citation count

  • 13

complete list of authors

  • Sorensen, Lisa G||Neighbors, Katie||Hardison, Regina M||Loomes, Kathleen M||Varni, James W||Ng, Vicky L||Squires, Robert H||Alonso, Estella M

publication date

  • May 2018