Congenital heart disease hospitalizations higher among adults than children

SAN FRANCISCO — Hospitalizations for adults with congenital heart disease have grown at a rate more than twice that for children from 1998 to 2010.

“As a result, annual adult admissions are approaching those of children, accounting for 36.5% of all congenital heart disease admissions,” Jared M. O’Leary, MD, of Brigham and Women’s Hospital, and colleagues reported at the American College of Cardiology Scientific Sessions and in a simultaneous publication in JAMA.

The researchers analyzed US hospitalizations for children and adults with congenital heart disease from 1998 to 2010 using the Nationwide Inpatient Sample, which includes 8 million annual admissions from approximately 1,000 hospitals. Two time periods were used to compare the number of hospitalizations — January 1998-June 2004 and July 2004-December 2010 — to minimize the effect of year-to-year variability.

Hospital admissions for adults were 87.8% higher from 2004-2010 (n=622,084) compared with 1998-2004 (n=331,162). Hospital admissions for patients aged younger than 18 years increased 32.8% in recent years (1,082,540 vs. 815,471).

For this study, congenital heart disease was classified as simple, complex or unclassified, using ICD-9 codes. Between the two eras, adult hospital admissions for simple defects changed 112.8%, complex defects changed 52.8% and unclassified defects changed 52.6%. Among children, simple defects changed 46.3%, complex defects changed 32.4% and unclassified defects changed –9.8%.

“The extent of medical comobidity was greater among adults, though this increased significantly for both children and adults over the study period,” the researchers wrote in a research letter.

The observed trend among adults may be due to better congenital heart disease survival, an aging population, accumulating comorbidities or limited availability of quality outpatient services, according to the researchers.

“There are more than 787,000 adults with congenital heart disease in the United States. Adults with congenital heart disease remain at risk for frequent hospitalizations,” O’Leary and colleagues wrote. “…Adult congenital heart disease admissions will have an increasing impact on resource utilization.” – by Katie Kalvaitis

For more information:

O’Leary JM. Poster #1290-120. Presented at: American College of Cardiology Scientific Sessions; March 9-11, 2013; San Francisco.

O’Leary JM. JAMA. 2013;309:doi:10.1001/jama.2013.564.

Disclosure:O’Leary reports no relevant financial disclosures.