Pediatric inpatient admissions for congenital heart disease were associated with significantly higher mortality (2.97% vs 0.31%) and adjusted median charges compared to non-CHD admissions (P<0.0001).
Observational (n=859,843)
Sí
Pediatric CHD admissions are increasingly resource-intensive and account for a growing proportion of all pediatric inpatient deaths, despite a decrease in the absolute mortality rate among these patients.
Tasa de eventos absoluta: 2.97% vs 0.31%
valor p: p=<0.0001
Background Children with congenital heart disease (CHD) are known to consume a disproportionate share of resources, yet there are limited data concerning trends in resource use and mortality among admitted children with CHD. We hypothesize that charges in CHD‐related admissions increased but that mortality improved over time. Methods and Results This study, including patients <18 years old with CHD, examined inpatient admissions from the nationally representative Kids' Inpatient Database from 2003 to 2016 in order to assess the frequency, medical complexity, and outcomes of CHD hospital admissions. A total of 859 843 admissions of children with CHD were identified. CHD admissions increased by 31. 8% from 2003 to 2016, whereas overall pediatric admissions decreased by 13. 4%. Compared with non‐CHD admissions, those with CHD were more likely to be <1 year of age (80. 5% versus 63. 3%), and to have ≥1 complex chronic condition (39. 7% versus 9. 3%). For CHD admissions, mortality was higher (2. 97% versus 0. 31%) and adjusted median charges greater (48 426 interquartile range (IQR), 11. 932–161 048 versus 4697 IQR, 2551–12 301) (P <0. 0001 for all). Among CHD admissions, whereas adjusted median charges increased from 35 577 (IQR, 9303–110 439) to 61 696 (IQR, 15 212–219 237), mortality decreased from 3. 2% to 2. 7% (P for trend <0. 0001). CHD admissions accounted for an increased proportion of all inpatient deaths, from 18. 0% in 2003 to 24. 5% in 2016. Conclusions Children admitted with CHD are 10 times more likely to die than those without CHD and have higher charges. Although the rate of mortality in CHD admissions decreased, children with CHD accounted for an increasing proportion of all pediatric inpatient deaths. Effective resource allocation is critical to optimize outcomes in these high‐risk patients.
Edelson et al. (Mon,) conducted a observational in Congenital heart disease (n=859,843). Congenital heart disease vs. Non-CHD admissions was evaluated on Mortality (p=<0.0001). Pediatric inpatient admissions for congenital heart disease were associated with significantly higher mortality (2.97% vs 0.31%) and adjusted median charges compared to non-CHD admissions (P<0.0001).