Geriatric Congenital Heart Disease
Key result
Dementia linked to ~3-fold higher mortality in geriatric patients with congenital heart disease.
- HR 3.24
- 95% CI 1.53 to 6.85
- n=3,239
Why the study?
The geriatric adult congenital heart disease (ACHD) population is increasing and aging but has yet to be characterized in terms of prevalence, disease burden, and mortality determinants.
Population
3,239 geriatric ACHD patients aged 65 years and older in Quebec
Design
Population-based cohort study using Quebec Congenital Heart Disease Database
Follow-up
Up to 15 years
Authors
Discussion
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Implication
In geriatric patients with congenital heart disease, mortality is predominantly driven by acquired general medical comorbidities rather than ACHD-related complications.
Key Points
- To measure the population prevalence, lesion distribution, and determinants of all-cause mortality in geriatric adults with congenital heart disease.
- Conducted a population-based cohort study using the Quebec Congenital Heart Disease Database from 1983 to 2005.
- Followed 3,239 adults aged 65 years and older with congenital heart disease for up to 15 years to evaluate all-cause mortality using Cox proportional hazards modeling.
- Geriatric congenital heart disease prevalence remained constant between 1990 and 2005 at 3.8 to 3.7 per 1,000 (prevalence odds ratio: 0.98; 95% CI: 0.93 to 1.03), primarily consisting of shunt lesions (60%), valvular lesions (37%), and severe defects (3%).
- Congenital heart defect type had minimal influence on survival, whereas acquired comorbidities were the primary drivers of all-cause mortality, led by dementia (HR: 3.24; 95% CI: 1.53 to 6.85), gastrointestinal bleeding (HR: 2.79; 95% CI: 1.66 to 4.69), and chronic kidney disease (HR: 2.50; 95% CI: 1.72 to 3.65).
Study Design
Type
Cohort (n=3,239)
Structured PICO
P
Population
3,239 adults aged 65 years or older with congenital heart disease, followed for up to 15 years.
O
Outcome
All-cause mortalityhard clinical
Main Result
Hazard Ratio: 3.24 (95% CI 1.53–6.85)
In geriatric patients with congenital heart disease, mortality is predominantly driven by acquired general medical comorbidities rather than ACHD-related complications.
Cite This Study
Afilalo et al. (2011) conducted a cohort in Congenital heart disease in geriatric adults (n=3,239). Acquired comorbid conditions (e.g., dementia) vs. Absence of comorbid conditions was evaluated on All-cause mortality (HR 3.24, 95% CI 1.53 to 6.85). In geriatric patients with congenital heart disease, acquired comorbidities were the strongest predictors of all-cause mortality, including dementia (HR 3.24; 95% CI 1.53-6.85).