Assessment of Intelligence Quotient (IQ) and Behavior in Children Post Cardiac Surgery in Early Childhood- A Prospective Observational Study

Abstract

Introduction: Congenital heart disease (CHD) is defined as a gross structural abnormality of the heart or intrathoracic great vessels that is actually or potentially of functional significance. The major deformities and motor delays can be easily identified. But the changes in neurodevelopment can be easily missed in outpatient follow-ups, which leads to affection on their academic performance and executive functioning at a later age. The goal of this study is to assess the impact of early childhood cardiac surgery on intelligence and behavior at a later age and to assess the factors responsible for the negative impact on intelligence and behavior. Methods: The study was conducted in a tertiary care hospital from June 2021 to September 2022 in 6–17-year age group children who underwent open heart surgery at any time in their first 5 years of life. On follow-up, the children were assessed clinically, and then intelligence and behavior were assessed using Raven’s standard progressive matrix and Childhood Behaviour Checklist, respectively. Previous data were collected from medical records. Results: 75 patients were included in the study. None of them had behavioral abnormalities. Socio-economic class [p-value 0.02], weight at first surgery [p-value 0.003], preoperative saturation [p-value 0.03], aortic cross-clamp time [p-value 0.007], and postoperative inhaled Nitric Oxide requirement [p-value 0.02] were observed to have a negative impact on intelligence. Conclusion: The level of intelligence and behavior in children after surgery has improved dramatically with a more negative impact on intellectual capacity observed with cyanotic congenital heart disease.