This study, published December 23, 2020 in Heart, compared outcomes and resource use among heart failure in adults with congenital heart disease and heart failure (ACHD-HF) vs. no ACHD: “Greater admissions, mortality and cost of heart failure in adults with congenital heart disease.” Researchers compared outcomes, emergency department (ED) and hospital resource use, and advanced heart failure therapies in ACHD-HF versus non-ACHD with HF (HF-non-ACHD).
They used The Nationwide Emergency Department Sample and Nationwide Inpatient Sample to evaluate outcomes and resource use among ACHD-HF ED visits and hospitalisations from 2006 to 2016. There were more than 76k ACHD-HF visits compared to 31M HF-non-ACHD visits.
Results You Should Know:
- ACHD-HFs were younger.
- ACHD-HFs had higher emergency department admissions, longer hospital length of stay, and greater hospital costs.
- Mortality rate was significantly higher among ACHD-HFs with single-ventricle or two-ventricle disease versus HF-non-ACHD.
- ACHD-HF received less advanced HF therapies compared to HF-non-ACHD.
ACTION members Danielle Burstein and Joseph Rossano of Children’s Hospital of Philadelphia were authors of this important study. Drs. Danielle Burstein and Joseph Rossano participate in QI initiatives through ACTION that focus on heart failure in children and adults with congenital heart disease. This research highlights the importance of using QI initiatives to improve outcomes and reduce resource utilization in complex populations of those with ACHD-related heart failure. It concludes that ACHD-HFs have had a significant increase in emergency department and hospital resource use over the past 10 years. However, advanced HF therapies are used less often including VAD and transplantation.
CITATION
Burstein DS, Rossano JW, Griffis H, Zhang X, Fowler R, Frischertz B, Kim YY, Lindenfield J, Mazurek JA, Edelson JB, Menachem JN. Greater admissions, mortality and cost of heart failure in adults with congenital heart disease. Heart. 2020 Dec 23:heartjnl-2020-318246. doi: 10.1136/heartjnl-2020-318246. Epub ahead of print. PMID: 33361349.
