Congenital Heart Disease has no Negative Impact on Educational Achievements and Employment among Maltese Adult Patients under Clinical Follow-Up

Maryanne Caruana, Victor Grech


Background: Most children born with congenital heart disease (CHD) nowadays survive into adulthood.  The aim of this study was to investigate the potential impact of CHD on educational achievements and employment in Maltese adult patients.

Methods: A bespoke self-reporting questionnaire based on the 2008 European Health Interview Survey (EHIS 2008) was distributed to 162 consecutive Maltese adult congenital heart disease (ACHD) patients at time of hospital follow-up for the 1-year period May 2013-May 2014.  Education and employment in the ACHD cohort were compared with those from 372 randomly-selected age- and sex-matched EHIS 2008 responders (general population cohort).  Chi-squared and Fisher Exact tests were used for categorical variables, and Mann-Whitney U test was applied to numerical variables.

Results:  There were 125 ACHD responders (65 males, mean age 30.64±12.80 years).  Nineteen patients had mild CHD, 85 had moderate lesions and 21 had severe disease.  Patients with moderate/severe CHD had undergone significantly more cardiac procedures (mean 1.79; 95% CI 1.56,2.02) compared to patients with mild disease (mean 0.68; 95% CI 0.40,0.96) (p<0.001).  There were no significant differences in educational achievements, employment rate or working patterns between the 2 cohorts, but significantly more ACHD patients had higher-skilled occupations (82.1%) compared to the general population (67.5%; p=0.01), with this difference being restricted to male subjects.  There were no significant differences in education and employment upon comparison of patients with mild and moderate/severe disease.

Conclusions:  This study suggests that, in Malta, ACHD has no negative impact on educational achievements and employment.


Congenital Heart Defects; Cardiac Surgical Procedures; Educational Achievements; Employment Status


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