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Adult congenital heart disease (ACHD) continues to rise. Heart failure (HF) is a frequent reason for admission. We sought to analyze the resource utilization of ACHD-related HF admissions at pediatric centers.
Data from the 40+ children's hospitals in the Pediatric Health Information Systems were used to identify patients aged ≥18 years admitted from 10/2005 to 09/2015 with an ICD-9 code for congenital heart disease (745.xx-747.xx) and principal and/or admission diagnosis of heart failure (428.xx). Demographic and diagnostic code data, length of stay (LOS), disposition, and adjusted estimated costs were analyzed. Admissions were categorized by anatomic complexity. High volume centers were stratified above the 90th percentile for number of admissions during the study period. Cost data were adjusted for the 2015 dollar.
There were 1,070 admissions during the study period. Median age was 24.0 years (IQR=19-32). Median LOS was 7.0 days (IQR=3-15). Mortality was 5.6%. Median estimated cost per admission was $23,829 (IQR=$10,050-$59,975) and $3,684 per patient day (IQR=$2,018-$6,153). Anatomic complexity was moderate/severe in 88.0%. Outcomes stratified by volumes are represented in table 1.
ACHD-related HF admissions to children's hospitals are associated with high costs. A majority have complex anatomies. Center volume is correlated with lower mortality, ER visits, and admissions to ICU despite similar ACHD complexity, LOS, and cost per admission.
Moderated Poster Contributions
Congenital Heart Disease and Pulmonary Hypertension Moderated Poster Theater, Poster Hall, Hall A/B
Monday, March 12, 2018, 1:15 p.m.-1:25 p.m.
Session Title: Trends in Hospitalization For Congenital Heart Disease
Abstract Category: 09. Congenital Heart Disease: Adult
Presentation Number: 1322M-09
- 2018 American College of Cardiology Foundation