Trends in hospitalizations for adults with congenital heart disease in the U.S

Abstract

Objectives: The purpose of this study was to better define the epidemiology of hospitalizations for adults with congenital heart disease (ACHD) in the U.S.

Background: There is a growing population of ACHD as the result of advances in pediatric care and diagnostic testing.

Methods: We used nationally representative data from the 1998 to 2005 Nationwide Inpatient Sample to identify patients > or =18 years of age admitted to an acute care hospital with an International Classification of Diseases-9th Revision code designating a CHD diagnosis. National estimates of hospitalizations and total hospital charges by year were calculated.

Results: The number of ACHD hospitalizations increased 101.9% from 35,992 +/- 2,645 in 1998 to 72,656 +/- 5,258 in 2005. During this period, the annual number of admissions grew for both simple (19,448 +/- 1,614 to 44,707 +/- 3,644) and complex (12,507 +/- 1,172 to 19,973 +/- 1,624) diagnoses. The percentage of admissions originating in the emergency department (41.7 +/- 0.8%) or involving cardiac surgery (17.7 +/- 0.7%) remained stable during the study period. The average patient age (52.3 +/- 0.8 years to 53.8 +/- 0.6 years, p < 0.0001) and proportion of patients with > or =2 medical comorbidities (23.3 +/- 0.9% to 33.0 +/- 0.7%, p < 0.0001) increased. Mean hospital charges per hospitalization increased 127% from 19,186 +/- 803 to 43,496 +/- 2,166 US dollars, and the estimated total national charges for these hospitalizations increased 357% from 691 million US dollars in 1998 to 3.16 billion US dollars in 2005 (in inflation-adjusted 2005 dollars).

Conclusions: The number of hospital admissions for ACHD in the U.S. more than doubled between 1998 and 2005. Hospital charges attributable to these admissions have grown even more dramatically.