Quality of life in children with acyanotic congenital heart disease: clinical determinants and management implications

Introduction. Acyanotic Congenital Heart Disease (ACHD) significantly impacts the quality of life (QoL) of affected children, leading to physical, cognitive, and social challenges. Despite global research, data on ACHD-related QoL in Southeast Asia, particularly Indonesia, remain scarce. Objective. This study aimed to analyze clinical factors influencing QoL in children with ACHD, focusing on cardiac, cognitive, and communication dimensions, which directly affect physical, developmental, and social functioning. Materials and methods. A descriptive-analytical study was conducted on 74 ACHD patients (aged 2–18 years) at Dr. Soetomo Hospital, Surabaya (February–July 2021). QoL was assessed using the Pediatric Quality of Life Inventory (PedsQL) 3.0 Cardiac Module, covering cardiac issues, therapy, cognitive function, and communication. One-way ANOVA was applied to compare QoL scores across diagnostic categories. Results. The overall mean QoL score was 73.89 ± 9.79, with significant variations between ACHD subgroups (p = 0.014). Patients with combined ACHD diagnoses had significantly lower QoL scores (56.48 ± 1.85) compared to isolated PDA, ASD, or VSD (p = 0.002 vs. PDA/ASD; p = 0.003 vs. VSD). The cognitive function (59.53 ± 18.40) and communication (71.40 ± 24.21) domains had the lowest scores, indicating developmental and social challenges. Conclusion. Children with combined ACHD diagnoses experience the most severe QoL impairments, particularly in cognitive and communication domains. These findings highlight the clinical need for targeted interventions, including early cognitive therapy, speech development programs, and multidisciplinary care to improve patient outcomes.