Outcomes of Adolescent-Onset Postural Orthostatic Tachycardia Syndrome

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• 作者：Roma Bhatia ; BS¹ ; Sarah J. Kizilbash ; MD¹ ; ² ; ^&lowast ; ; Shelley P. Ahrens ; DNP¹ ; ² ; Jill M. Killian ; BS¹ ; ³ ; Stephanie A. Kimmes ; CNP¹ ; ² ; Erin E. Knoebel ; MD¹ ; ² ; Prasuna Muppa ; MBBS¹ ; ² ; Amy L. Weaver ; MS¹ ; ³ ; Philip R. Fischer ; MD¹ ; ² ; ^{fischer.phil@mayo.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：chronic fatigue ; autonomic dysfunction ; dysautonomia ; dizziness
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：173
• 期：Complete
• 页码：149-153
• 全文大小：503 K

文摘

To determine the clinical course of adolescent-onset postural orthostatic tachycardia syndrome (POTS) and to assess health-related quality of life, 2-10 years after diagnosis.

Study design

Pediatric patients, 13-18 years of age, diagnosed with POTS at Mayo Clinic, Rochester, from 2003 to 2010 were mailed a questionnaire if they were at least 18 years of age at the time of the mailing. The primary outcome measures were norm-based, age- and sex-adjusted, 36-Item Short Form Health Survey physical composite score and mental composite score.

Results

The survey was mailed to 502 patients with a response rate of 34% (n = 172). The mean duration from diagnosis to survey completion was 5.4 (SD, 1.9) years; the mean age of the respondents at the time of the survey was 21.8 (2.2) years. The responders were predominantly females (84% vs 68% of nonresponders; P < .001). Only 33 (19%) respondents reported complete resolution of symptoms, and an additional 51% reported persistent but improved symptoms, and 28 (16%) had only intermittent symptoms. The majority (71%) consider their health at least “good.” The mean physical composite score was significantly lower than the population norm (mean [SD], 36.6 [15.8] vs 50; P < .001), however, the corresponding mean mental composite score was normal (50.1 [11.2]).

Conclusions

Overall, 86% of adolescents with POTS report resolved, improved, or just intermittent symptoms, when assessed via questionnaire at an average of 5 years after initial treatment. Patients with persistent symptoms have more physical than mental health concerns.