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Published on: July 18, 2014
Congenital heart defects -- occurrence, surgery and prognosis in a Danish County
1Epidemiology, University of Southern Denmark, Odense, Denmark. Egarne@health.sdu.dk
Insights
Congenital heart disease (CHD) affects 7.9 per 1000 births, with high mortality in infants and children. While surgical outcomes improved, survival for severely ill newborns remains a challenge.
Area of Science:
- Pediatric Cardiology
- Public Health
- Medical Malformations
Background:
- Congenital heart disease (CHD) represents a significant global health concern.
- Understanding population-based data on CHD prevalence, treatment, and outcomes is crucial for improving pediatric care.
Purpose of the Study:
- To provide population-based data on the prevalence, surgical interventions, and mortality rates of congenital heart disease (CHD) in children up to five years of age.
- To analyze trends in CHD outcomes over time.
Main Methods:
- Utilized data from the EUROCAT Registry of Congenital Malformations in Funen County, Denmark, spanning 1986-1998.
- Analyzed livebirth prevalence, intervention rates (surgery, catheter treatment), and mortality within the first five years of life.
Main Results:
- A livebirth prevalence of 7.9 per 1000 births was observed for CHD.
- Thirty-two percent of affected children underwent surgical or catheter treatment.
- Eighteen percent of children died within five years, predominantly in the early years of life; 74% of deaths occurred without prior surgery.
- A significant decline in mortality was noted in the later study period (1994-1998) compared to the earlier period (1986-1993).
- Deaths within 28 days post-surgery significantly decreased.
Conclusions:
- Infants and children with CHD experience high rates of mortality and morbidity, despite considerable improvements in surgical mortality.
- Further improvements in survival may be possible for critically ill newborns awaiting surgery.
- For newborns with multiple severe malformations, survival may not be feasible or advisable.
Objective:
To present population-based data on prevalence, surgery and mortality for infants and children up to 5 years of age with congenital heart disease (CHD).
Design:
Data from the EUROCAT Registry of Congenital Malformations for Funen County, Denmark, 1986-1998.
Results:
Five hundred and seventy-three infants and children were diagnosed with a CHD and livebirth prevalence was 7.9 per 1000 births. Thirty-two percent of all infants and children had an intervention (surgery or catheter treatment) performed. Eighteen percent died within the first 5 years with the majority of deaths within the first years of life. For 74% of all deaths, surgery had not been performed. There was a decline in mortality for 1994-1998 compared to 1986-1993 both as a percentage of all cases (p < 0.05) and all deaths per 1000 births (p = 0.13), and deaths within the first 28 d after surgery almost disappeared during the study period.
Conclusion:
Mortality and morbidity for infants and children with CHD is rather high although surgical mortality has improved considerably. Survival may be improved further for the small group of severely ill newborns dying before surgery. In newborns with multiple malformations, however, survival might not be possible or desirable.
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