Lesion-Specific Congenital Heart Disease Mortality Trends in Children: 1999 to 2017

OBJECTIVE Congenital heart disease (CHD) is a leading cause of premature death in infants and children. Currently limited data are available regarding lesion specific mortality over time. Our study aimed to describe pediatric mortality trends by CHD lesion in the United States. METHODS We conducted...

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Published inPediatrics (Evanston) Vol. 150; no. 4; p. 1
Main Authors Lynn, Melodie M., Salemi, Jason L., Kostelyna, Stefan P., Morris, Shaine A., Tejtel, S. Kristen Sexson, Lopez, Keila N.
Format Journal Article
LanguageEnglish
Published Evanston American Academy of Pediatrics 01.10.2022
Subjects
Age
Babies
Cardiovascular disease
Child mortality
Children
Congenital defects
Congenital diseases
Coronary artery disease
Death
Heart
Heart diseases
Infant mortality
Infants
Lesions
Mortality
Pediatrics
Risk factors
Statistical analysis
Tetralogy of Fallot
Trends
Ventricle
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Summary:OBJECTIVE Congenital heart disease (CHD) is a leading cause of premature death in infants and children. Currently limited data are available regarding lesion specific mortality over time. Our study aimed to describe pediatric mortality trends by CHD lesion in the United States. METHODS We conducted a 19 year analysis (1999 to 2017) of publicly available, deidentified multiple cause of death data compiled and produced by the National Center for Health Statistics. Analysis was stratified by CHD diagnosis and age using 3 age categories (infants, 1 to 4 years, and 5 to 17 years). Temporal trends of CHD mortality and the effect of contributing risk factors were analyzed by using joinpoint regression. RESULTS Mortality was highest for in infants for all CHD lesions, in particular for total anomalous pulmonary venous return. Significant declines in infant CHD mortality occurred for most other lesions. Contributing risk factors, including prematurity, extracardiac birth defects, and genetic conditions, occurred in 19% of infant CHD deaths and demonstrated worse mortality trends in the majority of lesions. Mortality rates remained highest for single ventricle lesions in all ages, with an infant mortality rate plateau in the later half of the study and progressive increasing mortality rates for children 5 to 17 years. CONCLUSIONS CHD mortality is decreasing for most lesions. Because of the heterogenicity of CHD lesions, there is expected variability in mortality trends by lesion and age group. Single ventricle lesions continue to contribute most heavily to premature death because of CHD demonstrated by significant increases in mortality rate for children aged 5 to 17 years. Topics:common ventricle, congenital abnormality, congenital heart disease, hypoplastic left heart syndrome, trend, genetics, infant, premature, cause of death, atrioventricular septal defect, tetralogy of fallot
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Dr Lynn collected data, carried out the initial analyses, drafted the initial manuscript, and reviewed and revised the manuscript; Dr Salemi conceptualized and designed the study, designed the data collection instruments, collected data, carried out the initial analyses, and reviewed and revised the manuscript; Drs Lopez, Morris, and Tejtel conceptualized and designed the study and reviewed and revised the manuscript; Dr Kostelyna drafted the initial manuscript and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2022-056294