Sex Differences in Hospital Mortality in Adults With Congenital Heart Disease
Key result
Male sex linked to ~36% higher 30-day in-hospital mortality in young adults with CHD.
- RR 1.36
- 95% CI 1.02-1.81
- n=39,776
Why the study?
The determinants of sex differences in the demographic distribution and hospital mortality of adults with congenital heart disease are poorly understood.
Population
39,776 adults with congenital heart disease aged 18 to 65 years with 54,195 hospital admissions
Comparison
Men versus women and women aged 18 to 45 years with versus without pregnancy history
Design
Cohort study using Quebec CHD database and Dutch CONCOR registry with regression analyses
Follow-up
259,741 patient years
Authors
Discussion
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Implication
Cohort study reveals lower in-hospital mortality in reproductive-aged women compared to men with congenital heart disease, suggesting biological factors confer survival advantages.
Key Points
- To evaluate sex differences in 30-day in-hospital mortality among adults with congenital heart disease and determine the association between pregnancy history and mortality in women.
- Analyzed data from the Quebec congenital heart disease (CHD) database and Dutch CONCOR registry, identifying 39,776 patients aged 18 to 65 followed for 259,741 patient-years between 1996 and 2005.
- Used multivariable regression to evaluate 30-day in-hospital mortality adjusted for age, CHD severity, underlying comorbidities, and admission diagnosis.
- In patients aged 18 to 45 years, 30-day in-hospital mortality was significantly higher in men compared with women with nonpregnancy admissions (adjusted RR: 1.36; 95% CI: 1.02 to 1.81).
- Women aged 18 to 45 with a history of pregnancy had reduced 30-day in-hospital mortality compared with those without (adjusted RR: 0.49; 95% CI: 0.24 to 0.99), despite having no overall increase in medical encounters.
Study Design
Type
Cohort (n=39,776)
Multicenter
Yes
PICO
P
Population
39,776 adults aged 18 to 65 years with congenital heart disease, of whom 19,099 were hospitalized between 1996 and 2005, followed for 259,741 patient-years.
E
Exposure / Comparator
Male sex vs Female sex
O
Primary Outcome
30-day in-hospital mortality — RR 1.36 (1.02-1.81)
Main Result
Relative Risk: 1.36 (95% CI 1.02–1.81)
Cite This Study
Zomer et al. (2013) conducted a cohort in Congenital heart disease (n=39,776). Male sex vs. Female sex was evaluated on 30-day in-hospital mortality (RR 1.36, 95% CI 1.02-1.81). Among adults aged 18 to 45 years with congenital heart disease, male sex was associated with higher 30-day in-hospital mortality compared with female sex (adjusted RR 1.36; 95% CI 1.02-1.81).