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Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Unscheduled hospitalization in adults with congenital heart disease
Jun Negishi1, Hideo Ohuchi1, Kenji Yasuda1
1Department of Pediatric Cardiology, National Cerebral Cardiovascular Center, Suita, Japan.
Insights
Adults with congenital heart disease (CHD) frequently require unscheduled hospitalizations (USH), often due to arrhythmias or heart failure. Understanding these triggers is crucial for improving care for this growing patient population.
Area of Science:
- Cardiology
- Adult Congenital Heart Disease
- Hospital Medicine
Background:
- Limited data exists on unscheduled hospitalizations (USH) in adult patients with congenital heart disease (CHD).
- Adult CHD populations are growing, necessitating a better understanding of their healthcare needs.
- Unscheduled hospitalizations represent a significant burden on patients and healthcare systems.
Purpose of the Study:
- To investigate the clinical features of adult patients with CHD requiring USH.
- To identify common causes and outcomes associated with USH in this population.
- To inform current medical care and therapeutic strategies for adult CHD patients.
Main Methods:
- Retrospective review of medical records for adult CHD patients (≥18 years) hospitalized over a 5-year period.
- Data collection focused on patient demographics, underlying heart conditions, reasons for USH, and prognosis.
- Prognostic factors included readmission and mortality.
Main Results:
- 145 adult CHD patients experienced 239 USHs; median age at USH was 27 years.
- Common underlying conditions included repaired tetralogy of Fallot (21%), Fontan physiology (17%), and Eisenmenger syndrome (12%).
- Primary causes for USH were arrhythmia (40%), heart failure (20%), infection (13%), and hemorrhage/thrombus (13%).
Conclusions:
- Adults with complex CHD have a high rate of USH.
- Arrhythmia, heart failure, infection, and bleeding/clotting complications are key drivers of USH.
- These findings highlight critical areas for improving medical care and addressing unmet needs in adult CHD patients in Japan.
Background And Objectives:
Little information is available regarding adult patients with congenital heart disease (CHD) who needed unscheduled hospitalization (USH). This paper aims to elucidate the clinical features of adult patients with CHD requiring USH.
Subjects And Methods:
Study subjects included patients with CHD aged 18 years or older who were hospitalized at our facility during a 5-year study period. Medical records were retrospectively reviewed and data regarding USH were collected. Patient's background, underlying heart disease, cause of hospitalization, and prognosis (second USH regardless of cause or death) were examined.
Results:
Overall, 959 CHD patients underwent a total of 1761 hospitalizations, including 145 patients who were unexpectedly hospitalized 239 times. The median age at USH was 27 years old. Of the 959 patients, 54% were male. Underlying heart diseases included repaired tetralogy of Fallot (21%), single ventricular physiology after Fontan operation (17%), and Eisenmenger syndrome (12%). The causes of USH included arrhythmia (40%), heart failure (20%), infectious disease (13%), and hemorrhage or thrombus (13%). A total of 48 patients required readmission. In total, 13 patients died, including four hospital deaths. The USH-free survival rate was 77% for 1 year and 58% for 3 years.
Conclusion:
The rate of USH was high for adults with complicated CHD. Common causes of USH included arrhythmia, heart failure, hemorrhage-related or thrombus-related conditions and infection. These data provide the current status of medical care for adult CHD patients in Japan and their therapeutic needs.
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