(213) Change in Quadriceps Muscle Layer Thickness to Functional Status and QOL in Children With CHD

Introduction: Children undergoing congenital cardiac surgery are at risk for lean body mass (LBM) loss during postoperative recovery. Quadriceps muscle layer thickness (QMLT) as a surrogate for LBM has been associated with functional outcomes after ICU admission in adults. Our aim was to compare perioperative changes in QMLT to functional status and quality of life changes during hospitalization in children with congenital heart disease (CHD).

Methods: Children (>3 months and < 17.5 yo) with CHD undergoing biventricular repair at a single institution were prospectively consented. QMLT measurements were performed preoperatively, on postoperative day 3 and 7, and at hospital discharge. Functional assessment (using the functional status score, FSS) and quality of life (using the Pediatric Quality of Life questionnaire, PedsQL, Core and Cardiac modules) were obtained preoperatively and at hospital discharge.

Results: 47 patients were enrolled over a one-year period; 27 (57%) were female with a median age at surgery of 32 [13.5, 55] months and a median weight-for-age z-score of -0.67 [-1.3, -0.32] (n=40). The median FSS score at admission was 6 [6,7] and at discharge was 7 [6,8]. The median PedsQL Core score at admission was 87 [67, 94] and at discharge was 73 [57, 84]. For the PedsQL Cardiac module, the median score at admission was 76 [56, 84] and at discharge was 77 [67,87]. The median admission QMLT was 1.7 [1.4, 2.0] cm and discharge was 1.6 [1.3, 1.9] cm with a median change of – 0.09 [-0.30, 0.08] cm over a medial LOS of 8 [7, 13] days. Change in QMLT was not associated with change in FSS score or FSS score at discharge (p=0.15 and p=0.61, respectively). Change in QMLT was not associated with change in PedsQL Core or Cardiac module scores (p=0.61 and p=0.63, respectively). Finally, change in QMLT was not associated with PedsQL and the cardiac module at discharge (p=0.19 and p=0.22, respectively).

Conclusions: Perioperative changes in QMLT are not associated with changes in functional status or quality of life during hospitalization. Further studies are needed to examine the medium- and long-term implications of LBM loss as it relates to functional status and quality of life in children with CHD.