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The emerging burden of hospital admissions of adults with congenital heart disease
  1. Carianne L Verheugt1,2,3,
  2. Cuno S P M Uiterwaal1,
  3. Enno T van der Velde4,
  4. Folkert J Meijboom5,
  5. Petronella G Pieper6,
  6. Gertjan Tj Sieswerda7,
  7. Herbert W M Plokker8,
  8. Diederick E Grobbee1,
  9. Barbara J M Mulder2,3,7
  1. 1Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
  2. 2Department of Cardiology, Academic Medical Centre, Amsterdam, The Netherlands
  3. 3Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands
  4. 4Department of Cardiology, Leiden University Medical Centre, Leiden, The Netherlands
  5. 5Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands
  6. 6Department of Cardiology, University Medical Centre Groningen, Groningen, The Netherlands
  7. 7Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands
  8. 8Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands
  1. Correspondence to Professor Barbara J M Mulder, Department of Cardiology, Room B2-240, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; b.j.mulder{at}amc.uva.nl

Abstract

Objective To assess the extent and the characteristics of hospital admissions in registered adult patients with congenital heart disease.

Design Observational cohort study.

Setting The Netherlands.

Patients 5798 adult patients with congenital heart disease from the Dutch CONCOR national registry linked to the Dutch National Medical Registration (Prismant).

Main outcome measures All hospital admissions from the years 2001 up until 2006.

Results During 28 990 patient-years, 2908 patients (50%) were admitted to hospital. Median age at admission was 39 years (range 18–86 years); 46% were male. Admission rate in CONCOR patients was high among all ages (range 11–68%) and exceeded that of the general Dutch population two to three times; this difference was most pronounced in the older age groups. Altogether there were 8916 admissions, 5411 (61%) of which were for cardiovascular indications. Among cardiovascular admissions, referrals for arrhythmias were most common (31%). Of 4926 interventions, 2459 (50%) were cardiovascular, most often reparative interventions or cardioversion (53%). Most non-cardiovascular admissions were obstetric. Among defects, univentricular heart and tricuspid atresia had the highest incidence and duration of admission.

Conclusions Healthcare utilisation in registered and medically supervised adult patients with congenital heart disease is high and increases with age. Admission rates are at least two times higher than in the general population, and most marked in the older age groups. With the ageing of this population, a major increase in healthcare utilisation is imminent in the near future. Timely preparation of healthcare resources is crucial to sustain optimal care.

  • Marfans
  • fallots tetralogy
  • transposition of the great arteries
  • epidemiology

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Footnotes

  • Funding Interuniversity Cardiology Institute of the Netherlands, and the Netherlands Society of Cardiology.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Academic Medical Centre, The Netherlands.

  • Provenance and peer review Not commissioned; not externally peer reviewed.

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