Changes of hospitalization trend in the pediatric cardiology division of a single center by increasing adult with congenital heart disease

Lee SY, Kim GB, Kwon HW, Song MK, Bae EJ, Cho S, Kwak JG, Lim HG, Kim WH, Lee JR.BMC Cardiovasc Disord. 2020 May 15;20(1):227. doi: 10.1186/s12872-020-01511-3.PMID: 32414329 Free PMC article.

 

Abstract

Background: As a result of advances in pediatric care and diagnostic testing, there is a growing population of adults with congenital heart disease (ACHD). The purpose of this study was to better define the epidemiology and changes in the trend of hospitalizations for ACHD in Korean society.

Methods: We reviewed outpatient and inpatient data from 2005 to 2017 to identify patient ≥18 years of age admitted for acute care with a congenital heart disease (CHD) diagnosis in the pediatric cardiology division. We tried to analyze changes of hospitalization trend for ACHD.

Results: The ratio of outpatients with ACHD increased 286.5%, from 11.1% (1748/15,682) in 2005 to 31.8% (7795/24,532) in 2017. The number of ACHD hospitalizations increased 360.7%, from 8.9% (37/414) in 2005 to 32.1% (226/705) in 2017. The average patient age increased from 24.3 years in 2005 to 27.4 in 2017. The main diagnosis for admission of ACHD is heart failure, arrhythmia and Fontan-related complications. The annual ICU admission percentage was around 5% and mean length of intensive care unit (ICU) stay was 8.4 ± 14.6 days. Mean personal hospital charges by admission of ACHD increased to around two times from 2005 to 2017. (from $2578.1 to $3697.0). Total annual hospital charges by ACHD markedly increased ten times (from $95,389.7 to $831,834.2).

Conclusions: The number of hospital cares for ACHD dramatically increased more than five times from 2005 to 2017. We need preparations for efficient healthcare for adults with CHD such as a multi-dimensional approach, effective communication, and professional training.

 

Fig. 1 a Annual number of out-patient clinic and (b) annual number of admission patients in the pediatric cardiology division. The ratio of outpatients with ACHD increased 286.5%, from 11.1% (1748/15,682) in 2005 to 31.8% (7795/24,532) in 2017. The number of ACHD hospitalizations increased 360.7%, from 8.9% (37/414) in 2005 to 32.1% (226/705) in 2017

 

Fig. 2 Age of Adult patients at admission in the pediatric cardiology division. The mean age of adult patients at admission increased from 24.3 to 27.4 years

 

Fig. 3 Annual Number of Adult Admissions by level of defect complexity. The ratio of patients with complex CHD did not change from 2005 to 2017 and it was from 70 to 80%

 

Fig. 4 Annual Number of Admissions for Adults with congenital heart disease diagnoses. Functional single ventricle was the most common single complex diagnosis in all years and tetralogy of Fallot (TOF) was second

 

Fig. 5 a Mean personal hospital charges and (b) Total annual hospital charges for admission of adults with congenital heart disease (US dollars). Mean personal hospital charges by admission of ACHD increased to around two times from 2005 to 2017. (from $2578.1 to $3697.0). Total annual hospital charges by ACHD markedly increased ten times (from $95,389.7 to $831,834.2)

 

 

source:https://pubmed.ncbi.nlm.nih.gov/32414329/

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