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Follow-up of tetralogy of Fallot patients: tertiary centre versus satellite clinic

Published online by Cambridge University Press:  13 May 2011

Camille L. Hancock Friesen ,
Mark Robertson ,
David Liu ,
Haley Burton ,
Katherine Fleming ,
Simon Jackson  and
Andrew E. Warren
Camille L. Hancock Friesen*
Affiliation:
Faculty of Medicine, Department of Surgery, Dalhousie University, Halifax, NS, Canada Department of Surgery, Dalhousie University, Halifax, NS, Canada Dalhousie University, Halifax, NS, Canada
Mark Robertson
Affiliation:
Faculty of Medicine, Department of Surgery, Dalhousie University, Halifax, NS, Canada Dalhousie University, Halifax, NS, Canada
David Liu
Affiliation:
Faculty of Medicine, Department of Surgery, Dalhousie University, Halifax, NS, Canada Dalhousie University, Halifax, NS, Canada
Haley Burton
Affiliation:
Department of Surgery, Dalhousie University, Halifax, NS, Canada
Katherine Fleming
Affiliation:
Faculty of Medicine, Department of Surgery, Dalhousie University, Halifax, NS, Canada Dalhousie University, Halifax, NS, Canada
Simon Jackson
Affiliation:
Faculty of Medicine, Department of Surgery, Dalhousie University, Halifax, NS, Canada Department of Medicine, Dalhousie University, Halifax, NS, Canada Dalhousie University, Halifax, NS, Canada
Andrew E. Warren
Affiliation:
Faculty of Medicine, Department of Surgery, Dalhousie University, Halifax, NS, Canada Department of Pediatrics, Dalhousie University, Halifax, NS, Canada Dalhousie University, Halifax, NS, Canada
*
Correspondence to: Dr C. L. Hancock Friesen, Department of Surgery, Head Pediatric Cardiac Surgery, Dalhousie University, 2269-1796 Summer Street, Halifax, NS, B3H 3A7 Canada. Tel: (902)473-7597; Fax: (902)473-4448; E-mail: camillehf@hotmail.com
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Abstract

Background

Canadian Cardiovascular Society consensus guidelines recommend that tetralogy of Fallot patients be seen by a congenital cardiologist every 2 years. In Atlantic Canada, tetralogy of Fallot patients are followed up at either tertiary or satellite clinics, which are held in the community and attended by paediatric cardiologists. The effectiveness of satellite clinics in congenital cardiac disease follow-up is unproven. Our objective was to compare patient-reported quality of life measures to determine whether these were impacted by the site of follow-up.

Methods

We included patients with tetralogy of Fallot undergoing surgical repair at the Izaak Walton Killam Health Centre from 1 November, 1972 to 31 May, 2002. Quality of life surveys, SF-10 or SF-36v2, were administered to consenting patients. We analysed the subjective health status by patient age and site of follow-up.

Results

Of the 184 eligible patients, 72 were lost to follow-up. Of the locatable patients, 61% completed the questionnaires. In all, 90% (101 out of 112) were followed up at recommended intervals. Of the 112 (68%) patients, 76 were followed up at a tertiary clinic. These patients were older, with a mean age of 18.4 years versus 14.7 years, and scored higher on the SF-36 physical component summary (52.6 versus 45.7, p = 0.02) compared with satellite clinic patients. The SF-36 mental component summary scores were similar for patients regardless of the site of follow-up. SF-10 physical and psychosocial scores were similar regardless of the site of follow-up.

Conclusion

Tetralogy of Fallot patients followed at either satellite or tertiary clinics have similar subjective health status.

Keywords

Congenital cardiac diseasesurgeryhealth statustransition of care
Type
Original Articles
Information
Cardiology in the Young , Volume 21 , Issue 4 , 12 July 2011 , pp. 444 - 453
Copyright
Copyright © Cambridge University Press 2011

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