Quality of Life in Congenital Heart Disease Patients according to Their Anatomical and Physiological Classification

Background: Living well is as important as living longer. The objective of this study is to assess quality of life (QoL) in congenital heart disease (CHD) according to current AHA/ACC anatomical and physiological classifi- cation. Methods: Cross-sectional study examining the World Health Organization QoL Bref questionnaire (WHOQoL-Bref) in consecutive outpatient CHD patients from a single unit. Results: 191 CHD patients were studied. Median age was 28 +/- 13 years and 59% were male. 44 (23%), 115 (60%) and 33 (17%) CHD patients showed mild, moderate and great anatomical defects respectively while 69 (36%) patients were in physiological Stage A, 27 (14%) in Stage B, 84 (44%) in Stage C and 11 (6%) in Stage D. No significant differences were seen in relation the anatomical classification and the different sections of the WHOQoL-Bref questionnaire. CHD patients in Stages C and D had significant lower physical domain scores than patients in the Stage A (p < 0.05). However, no significant differences were seen in the psychological, social relationships and environmental domains. The binary logistic regression analysis showed that having a higher educational level was a protective factor [OR 0.32 (95% CI, 0.12-0.87), p = 0.026] while being married or cohabit was a risk factor [OR 3.46 (95% CI, 1.13-10.63), p = 0.030] for having a worse rated QoL. Meanwhile, having a worse functional class (NYHA >= 2) [OR 3.44 (95% CI, 1.20-9.81), p = 0.021] was associated with dissatisfaction with health. Conclusion: Patients with advanced physiological stages scored lower on the physiological domain. No statistical significance was seen, according to the anatomical and physiological classification, in the psychological, social relationship and environmental domains.