Adult Congenital Heart Disease Patients Face Worse Outcomes After Surgery
Adult patients with congenital heart disease (CHD) who undergo cardiac surgery have higher hospital costs and worse outcomes after surgery, according to a recent study.
Advances in pediatric cardiac surgery and medicine have helped increase survival of CHD patients. In fact, many CHD patients now survive long enough to require cardiac surgery as adults.
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The researchers identified eligible patients using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9 CM) procedure codes. During the study, the researchers compared costs and outcomes for adult CHD patients undergoing cardiac surgery with a reference group of patients undergoing coronary artery bypass grafting (CABG), using information from the 2013 Nationwide Inpatient Sample (NIS) database.
Demographic characteristics including gender, ethnicity, hospital bed size, hospital length of stay, in-hospital mortality, and comorbidities were recorded.
Results of the analysis indicated that adult patients with CHD experience higher rates of in-hospital mortality and complications, including neurologic complications, thromboembolic complications, arrhythmias, hepatic failure, and sepsis, compared with CABG patients.
Additionally, costs were higher for adult CHD patients with neurologic complications, thrombotic complications, sepsis, acute kidney injury, elective cases, and a length of stay longer than 6 days.
“This study shows that [adult CHD] patients undergoing cardiac surgery experience higher hospital costs and poorer outcomes than a reference population of adult CABG patients,” the researchers concluded. “Recognition and treatment of comorbidities in ACHD patients undergoing cardiac surgery may provide an opportunity to improve perioperative outcomes in this growing patient population.”
—Christina Vogt
Reference:
Nasr VG, Faraoni D, Valente AM, DiNardo JA. Outcomes and costs of cardiac surgery in adults with congenital heart disease [Published online July 1, 2017]. Pediatr Cardiol. doi:10.1007/s00246-017-1669-7.