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Hospitalisations of children and adults with Hypoplastic Left Heart Syndrome in Texas from 2009 to 2019
Andrew Well1,2, Catherine Dawson1,3, Gregory Johnson1,4
1Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin and Dell Children's Medical Center, Austin, TX, USA.
Insights
Discharges for Hypoplastic Left Heart Syndrome (HLHS) patients have significantly increased, especially in older age groups. This trend highlights the growing need for comprehensive care as the HLHS population ages.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Epidemiology
- Healthcare Outcomes Research
Background:
- Hypoplastic Left Heart Syndrome (HLHS) remains a major cause of congenital heart disease (CHD) morbidity and mortality.
- Despite advancements in care, understanding patient discharge trends is crucial for resource allocation and future planning.
Purpose of the Study:
- To analyze the number, reasons, and trends of patient discharges for Hypoplastic Left Heart Syndrome (HLHS) in Texas over an 11-year period (2009-2019).
- To identify demographic and clinical characteristics associated with HLHS discharges.
Main Methods:
- Utilized the Texas Inpatient Discharge Dataset Public Use File (2009-2019).
- Included discharges of patients aged 5 years and older with HLHS diagnosis codes.
- Performed descriptive and univariate statistical analyses on diagnoses and procedures.
Main Results:
- Identified 1024 HLHS discharges, showing a 16.9% annual increase.
- Median length of stay was 4 days, with 1.7% in-hospital mortality.
- Older patients (25+ years) had higher uninsured rates (17.1%).
- 21.9% of discharges involved procedures, including 23 heart transplants.
Conclusions:
- HLHS discharges are rapidly increasing, particularly in older patient cohorts.
- Discharges are distributed across numerous hospitals, with a few facilities handling a majority.
- Further research is needed to address the complex care needs of an aging HLHS population.
Introduction:
Hypoplastic Left Heart Syndrome accounts for a significant proportion of CHD morbidity and mortality, despite improvements in care and improved survival. This study evaluates number of, reasons for, and trends in discharges of patients with hypoplastic left heart syndrome over 11 years in Texas.
Methods:
The Texas Inpatient Discharge Dataset Public Use File captures almost all discharges in Texas and was reviewed from 2009 to 2019. Discharges of patients ≥5 years of age and diagnosis codes for Hypoplastic Left Heart Syndrome were included. The admitting and principle diagnoses were categorised and all discharges were evaluated for procedures performed. Descriptive and univariate statistical analyses were performed.
Results:
A total of 1024 discharges were identified with a 16.9% annual increase over the study period. Median length of stay was 4 [IQR: 2-8] and there were 17 (1.7%) in-hospital mortalities with no differences across age groups. Seven (17.1%) discharges of patients 25+ years were uninsured, higher than other age groups (p < 0.001). The most common admitting diagnosis was CHD and 224 (21.9%) of discharges included a procedure, including 23 heart transplants. Discharges occurred from 67 different hospitals with 4 (6.0%) representing 71.4% of all discharges.
Conclusions:
Discharges of Hypoplastic Left Heart Syndrome have increased rapidly, particularly in the older age groups and were spread over a large number of hospitals. Further work is needed to understand the interplay between Hypoplastic Left Heart Syndrome and other conditions and care experiences that occur within the general population, which will become more common as this population ages and grows.
