203 - Characterizing Driving Outcomes at the Transition to Adulthood in Patients with Congenital Heart Disease.

The population of adults with congenital heart disease (CHD) now outnumbers children with CHD, with a sizeable proportion of these adults being considered as “emerging” adults. Emerging adulthood (approximately 18 - 26 years) encompasses the transition from adolescence to independent adulthood. This transition presents challenges to the adolescent negotiating across multiple domains such as education, employment, financial independence, and more. Driving a motor vehicle can be critical to achieving adult independence, enhancing access to social, community and employment opportunities. However, driving is also a highly complex and high-risk behavior: crashes remain a leading cause of death for adolescents and young drivers are overrepresented in crashes. With the growing population of emerging adults with CHD there is a need to characterize this population in terms of driving outcomes, which could be an index of neurodevelopmental function.

Objective:

This cross-sectional survey study aims to describe licensing, risky driving and crash outcomes among in a sample of emerging adults with CHD.

Design/Methods:

This study utilized a cohort of emerging adults with CHD who have been followed from childhood to evaluate the neurodevelopmental and other sequalae after infant cardiac surgery. In 2022, a driving survey was sent to the cohort and we collected responses from n=158: Mean Age at time of survey = 21.2 years. The survey included licensing history questions, crash history questions, as well as a modified Driver Behaviour Questionnaire (mDBQ) capturing risky driving habits and behaviors.

Results:

In this sample, 69% (n=109) reported having a driving history, and 93% of those were fully licensed. The majority (73%) were licensed before age 18 had had been driving for 3.5 years, on average, at the time of the survey. The majority (77%) reported taking some form of formal driver education before licensure, with 54% taking behind the wheel lessons through a private driving school. Twenty-eight percent reported involvement in at least one crash and 23% received citations for driving violations. More than half of the sample (55-75%) also engaged in risky driving behaviors such as ignoring speed limits, impatiently passing on the right, distracted driving and cell phone use while driving. 

Conclusion(s):

Adolescents and young adults with CHD are seeking and obtaining licensure for driving, and about a third end up involved in crashes as young drivers. Future work should examine neurodevelopmental and other individual risk factors that may predict licensing and crash outcomes in adults with CHD.