Complex assessment of severity and clinical functional status in adults with congenital heart disease

The aim — to estimate the severity and clinical functional status in adults with congenital heart disease (ACHD).Materials and methods. The study included 456 consecutive adults with CHD who were admitted to Scientific and Practical Medical Center of Pediatric Cardiology and Cardiac Surgery of Health Ministry of Ukraine (Kyiv, Ukraine) from January 1, 2014 to December 31, 2015. The average age was 27.4 ± 0.5 years (from 18 to 67 years), men were 225 (49.3 %), women — 231 (50.7 %). The severity of CHD was assessed using 2 scales: the severity of primary diagnosis (scale 1), and Disease severity index (scale 2); the functional status — by Ability index, (scale 3), Congenital heart disease functional index (scale 4) and NYHA functional class (FC) of heart failure (scale 5).Results and discussion. There were statistically significant differences in FC I, III and IV between complex and simple CHD, in FC II, III and IV between complex and moderate CHD and in FC I, II between moderate and simple CHD by Scale 3. There were statistically significant differences in FC II, IV and V between complex and simple CHD, in FC II­V between complex and moderate CHD and in FC I — III between moderate and simple CHD by Scale 4. The comparative analysis of scale 5 and scale 1 presented the same statistically significant differences compared to scale 3.Conclusions. The preserved functional clinical status of adults with congenital heart disease, absence of limitation of physical activity in everyday life, the opportunity to be engaged in work or study full day should be the main criteria for assessing the health in this cohort of patients, despite the complexity of congenital heart disease, previous surgical and/or percutaneous interventions.