The emerging burden of hospital admissions of adults with congenital heart disease

• Published in: Heart (British Cardiac Society) Vol. 96; no. 11; pp. 872 - 878
• Main Authors: Verheugt, Carianne L, Uiterwaal, Cuno S P M, van der Velde, Enno T, Meijboom, Folkert J, Pieper, Petronella G, Sieswerda, Gertjan Tj, Plokker, Herbert W M, Grobbee, Diederick E, Mulder, Barbara J M
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01.06.2010; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adolescent; Adult; Adults; Aged; Aged, 80 and over; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Classification; Congenital diseases; Cost of Illness; Data analysis; Defects; Emergency medical care; Epidemiologic Methods; epidemiology; fallots tetralogy; Female; Heart; Heart Defects, Congenital - economics; Heart Defects, Congenital - epidemiology; Hospitals; Humans; Male; Marfans; Medical prognosis; Medical sciences; Middle Aged; Mortality; Netherlands - epidemiology; Patient Admission - economics; Patient Admission - statistics & numerical data; Patient admissions; Physicians; Pulmonary arteries; Surgery; transposition of the great arteries; Young Adult; Netherlands; Europe; Human; Hospital admission; Cardiovascular disease; Adult; Circulatory system; Cardiology; Congenital cardiopathy
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/hrt.2009.185595

ObjectiveTo assess the extent and the characteristics of hospital admissions in registered adult patients with congenital heart disease.DesignObservational cohort study.SettingThe Netherlands.Patients5798 adult patients with congenital heart disease from the Dutch CONCOR national registry linked to the Dutch National Medical Registration (Prismant).Main outcome measuresAll hospital admissions from the years 2001 up until 2006.ResultsDuring 28 990 patient-years, 2908 patients (50%) were admitted to hospital. Median age at admission was 39 years (range 18–86 years); 46% were male. Admission rate in CONCOR patients was high among all ages (range 11–68%) and exceeded that of the general Dutch population two to three times; this difference was most pronounced in the older age groups. Altogether there were 8916 admissions, 5411 (61%) of which were for cardiovascular indications. Among cardiovascular admissions, referrals for arrhythmias were most common (31%). Of 4926 interventions, 2459 (50%) were cardiovascular, most often reparative interventions or cardioversion (53%). Most non-cardiovascular admissions were obstetric. Among defects, univentricular heart and tricuspid atresia had the highest incidence and duration of admission.ConclusionsHealthcare utilisation in registered and medically supervised adult patients with congenital heart disease is high and increases with age. Admission rates are at least two times higher than in the general population, and most marked in the older age groups. With the ageing of this population, a major increase in healthcare utilisation is imminent in the near future. Timely preparation of healthcare resources is crucial to sustain optimal care.