(P067) CHANGE IN PATIENT-REPORTED PHYSICAL AND MENTAL HEALTH AFTER ADULT CONGENITAL HEART DISEASE INTERVENTIONS

Background: Psychosocial challenges are well-described among adults with congenital heart disease (ACHD), the most common congenital defect across Canada. As ACHD patients undergo multiple diagnostic and procedural interventions over their lifetime, understanding patient-reported care outcomes can help inform standards of care. However, no literature explores the impact of ACHD interventions on patient-reported outcomes. We aimed to examine patient-reported mental and physical health status 30-days after a diagnostic or interventional ACHD procedure.

METHODS AND RESULTS: A prospective registry at the Toronto General Hospital (Canada) between 2022 and 2023 captured patient demographics, health and symptom profiles, and patient-reported physical and mental health through the PROMIS Global Health Questionnaire. Patients were surveyed at baseline and 30 days after an ACHD procedure. Global mental (GMH) and physical health (GPH) scores were derived and standardized using the PROMIS scoring manual, with 50 points as the mean of the general U.S. population and a MIC of 3 points.

In our sample of 156 patients, patent foramen ovale (PFO) closure and diagnostic catheterization of complex CHDs were the most common procedures (43.9% and 35.8%, respectively). Palpitations were the most commonly reported symptom before the procedure (21.7%), with increasing proportions at 30-days (33.3%, p< 0.0001). At baseline, the median GMH and GPH scores were 48.3 (IQR:7.5) and 47.7 (IQR: 14.3) respectively, within one standard deviation of the general population. At 30 days, no significant change in median GMH and GPH were observed in the overall sample. However, 47.4% and 64.7% of the sample had a clinically meaningful improvement or decline in their GMH or GPH score (above the MIC of 3). In patients experiencing an improvement in GMH and GPH T-scores, median within-person change of 3.5 (IQR:2.7) and 5.6 (IQR: 4.5) was statistically and clinically meaningful. In patients experiencing worsening, average within-person change of GMH and GPH T-scores were -5.0 (IQR: 4.8) and -4.2 (IQR: 4.1) respectively, and clinically meaningful. Median change in GMH and GPH scores was 2.3 (IQR:9.2) and 2.5 (IQR:8.3) after atrial septal defect closure, and 0.0 (IQR:8.4) and 0.0 (IQR:7.5) after PFO closure. Categorical scores (excellent, very good, good, fair, or poor health) were derived using the PROMIS guidelines and change from baseline to follow-up is visualized in Figure 1.

Conclusion: Patients experienced both clinically meaningful improvement and decline in mental and physical self-reported health after ACHD interventions. Future analyses should explore predictors of divergent change to influence patient-centred decision-making.