The study, led by Dana Connolly, Ph.D., Assistant Professor of Pediatrics at New York University School of Medicine in collaboration with Michael Artman, M.D., Director of Pediatric Cardiology at New York University School of Medicine, is the first of its kind to examine the psychosocial responses of school-age children to cardiac surgery. Forty-three families participated in the study, which took place at New York University Medical Center and Children's Medical Center in Dallas. The children from five-to- twelve years of age underwent cardiac surgery for congenital heart defects. Each child was evaluated pre- and post-operatively for PTSD using tools that determine anxiety disorders, nonverbal reasoning, and temperament. None of the children showed signs of PTSD before surgery.
During the post-surgical assessment, researchers found that characteristics of PTSD increased in children who stayed in the ICU for more than 48 hours after surgery. After hospitalization, five (12%) of the children met diagnostic criteria for PTSD, and five (12%) exhibited some of the characteristics of PTSD, including disorganized behavior, nightmares, sleep disorders, and concentration problems. Children exhibiting signs of PTSD were referred to pediatric psychiatrists for further evaluation.
"It's important for parents to look for behavioral changes such as bed wetting, night screams, clinging, and concentration problems once the child comes home from surgery," says Dr. Connolly. Despite efforts to minimize the stress and emotional trauma that can be associated with heart surgery for children and their families, the study showed, for the first time, a clinically significant risk of PTSD after cardiac surgery in pediatric patients.
According to Dr. Artman, "Even though this was a relatively small sample, it is impressive that roughly 1 in 10 children develop full blown post-traumatic stress disorder after undergoing heart surgery. The only factor we found that seemed to correlate with PTSD was a stay of more than 48 hours in the ICU, which is really not very long. Presently, we don't know what factors in the ICU might be contributing, but our new findings clearly demonstrate the need for future research."
Congenital heart disease affects 1 in 100 newborn babies each year, according to the American Heart Association, and is the most common form of birth defect. In the United States, approximately 35,000 children are born with a structural heart defect every year, and many require surgery.
For additional information contact NYU's Department of Pediatric Cardiology at 212-263-5940.
The Journal of Pediatrics