Hospitalization for congenital heart disease is increasing at a greater rate among adults than among children, according to a study.
Jared M. OLeary, MD, of Brigham and Womens Hospital in Boston, and colleagues analyzed U.S. hospitalizations from 1998 through 2010 for children and adults with congenital heart disease. There are more than 787,000 adults with congenital heart disease in the United States, the authors wrote in a research letter that was published March 7 on the website of the Journal of the American Medical Association. Adults with congenital heart disease remain at risk for frequent hospitalizations.
The researchers identified congenital heart disease admissions to acute care hospitals from 1998 through 2010 using the Nationwide Inpatient Sample, a stratified 20% sample of hospitalizations, including approximately 8 million admissions annually from approximately 1,000 hospitals. The primary outcome was the change in number of admissions for all congenital heart disease diagnoses for pediatric (younger than 18) vs. adult patients. To minimize the effect of year-to-year variability, hospitalizations were compared between the first and second halves of the study (January 1998 through June 2004; July 2004 through December 2010).
The authors found that the frequency of hospitalizations for adults with congenital heart disease has grown at a rate more than twice that for children. Adult admission volume was 87.8% higher during the second half of the study compared with the first half, while pediatric admissions grew 32.8%. Adults accounted for 36.5% of congenital heart disease admissions in the later time span, up from 28.9%.
The observed trend is likely due to a number of independent forces including better congenital heart disease survival, an aging population and accumulating comorbidities, the authors wrote. Limited availability of quality outpatient services may also contribute.
Adult congenital heart disease admissions will have an increasing impact on resource utilization. Further research and focus on optimizing healthcare delivery is warranted to effectively care for adults with congenital heart disease.
The study is scheduled for presentation at the American College of Cardiologys annual Scientific Sessions, March 9-11 in San Francisco, and is available online at http://jama.jamanetwork.com/article.aspx?articleid=1656624.