Attentional symptoms, preoperative oxygenation and quality of life after arterial switch repair of D-transposition of the great arteries - Summary - MDSpire
To assess whether parent-reported behavioural symptoms or global cognition were more strongly associated with quality of life in Thai children with repaired D-TGA, and to examine associations with preoperative oxygen saturation.
Approach:
Design and participants: Single-centre exploratory cross-sectional study of 24 children aged 4–18 years who underwent arterial switch repair at Chiang Mai University.
Measures and analysis: Children completed the KBIT-2; parents completed the SDQ, SNAP-IV and PedsQL. Medical records provided preoperative pre-ductal SpO₂. Associations were assessed using Spearman correlations; IQ regression was adjusted for mode of delivery.
Key Findings:
Mean KBIT-2 composite IQ was 89.0 (SD 15.7); 11 of 24 children (45.8%) scored below 90.
Lower total PedsQL scores were associated with greater SNAP-IV inattention (rs=−0.63, p=0.001) and more SDQ peer problems (rs=−0.72, p<0.001); prosocial behaviour was positively associated with PedsQL (rs=0.76, p<0.001).
KBIT-2 IQ was not significantly associated with total PedsQL (rs=0.24, p=0.269), and PedsQL did not differ significantly between IQ groups below versus at least 90.
Preoperative pre-ductal SpO₂ was associated with total PedsQL (rs=0.42, p=0.048) and, after adjustment for mode of delivery, with IQ (B=0.94 per 1% SpO₂; 95% CI 0.28–1.60; p=0.008).
Interpretation:
In this sample, parent-reported attention and peer-functioning measures were more strongly associated with quality of life than global IQ. The authors describe preoperative SpO₂ as a candidate physiological marker, not a causal exposure, and advise caution in interpreting the association.
Limitations:
Small, single-centre sample and cross-sectional design.
Preoperative SpO₂ was abstracted retrospectively from a single measurement.
Outcomes relied on parent reports.
No correction was made for multiple testing.
Conclusion:
The authors state that brief parent-reported screening of attention and peer functioning may complement cognitive assessment during long-term follow-up after D-TGA repair.
