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Characteristics and Outcomes of Adults With Congenital Heart Disease in the Cardiac Intensive Care Unit

Ryan R Keane1, Anthony P Carnicelli2, Daniel B Loriaux3

  • 1Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

JACC. Advances
|August 13, 2024
PubMed

Insights

Adult congenital heart disease (ACHD) patients admitted to cardiac intensive care units (CICUs) are younger and present with more complex conditions. Despite longer hospital stays, ACHD admissions showed similar in-hospital mortality rates compared to other patients.

Area of Science:

  • Cardiology
  • Intensive Care Medicine
  • Congenital Heart Disease

Background:

  • Adult congenital heart disease (ACHD) patient care in cardiac intensive care units (CICUs) is not well understood.
  • Limited data exists on the specific characteristics, treatment, and outcomes for ACHD patients admitted to CICUs.

Purpose of the Study:

  • To define the contemporary epidemiology of ACHD admissions in North American CICUs.
  • To analyze treatment patterns and outcomes for ACHD patients in CICUs.
  • To compare ACHD admissions with non-ACHD admissions in the CICU setting.

Main Methods:

  • Prospective data collection from consecutive CICU admissions across 42 North American sites (2017-2022).
  • Analysis of patient characteristics, reasons for admission, and outcomes for ACHD vs. non-ACHD patients.
  • Multivariable logistic regression to assess mortality differences.

Main Results:

  • ACHD admissions (1.9% of 23,299) were younger (median 46 years) and more frequently admitted for heart failure, general medical issues, and atrial arrhythmias.
  • ACHD patients had higher median Sequential Organ Failure Assessment scores and longer hospital stays.
  • In-hospital mortality was not significantly different between ACHD and non-ACHD admissions (12.7% vs. 13.6%).

Conclusions:

  • ACHD admissions to CICUs present unique challenges and patient profiles.
  • Further research is needed to optimize management strategies for specific ACHD-related critical care scenarios.
  • The findings highlight the distinct needs of ACHD patients within the CICU environment.
Abstract

Keywords:
ACHDCICUadult congenital heart diseasecardiac intensive care unit

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