Trends in adult congenital heart disease hospitalization in Texas over the past decade

There are more than 1.4 million adult congenital heart disease (ACHD) patients estimated in the United States. As this population continues to grow, as will their utilization of the healthcare system. This study aims to analyze trends in discharges of ACHD patients in the state of Texas from 2009 through 2018. This is a retrospective review of the Texas Inpatient Discharge Public Use File from 2009 through 2018. Discharges from acute care hospitals of patients ≥18 years of age with an International Classification of Diseases 9 or 10 diagnosis code consistent with a CHD diagnosis which could be categorized by the American Heart Association/American College of Cardiology lesion severity score (LSS). Isolated atrial septal defect and congenital aortic valve insufficiency diagnoses were excluded from the analysis. A total of 10,515 ACHD discharges were identified. Annual discharges increased from 930 to 1,315, a 41% increase during the study period (p-trend<0.001). This increase was driven by a 70% increase in LSS 2 and a 125% increase in LSS 3 discharges. (p-trend <0.001 for both). Discharges of patients ≥50 years of age increased 60% (p-trend = 0.008) as did concomitant diagnoses of traditional cardiovascular risk factors including diabetes, chronic kidney disease, and hyperlipidemia (p-trend<0.001 for all). Overall in-hospital mortality was 0.18% and was unchanged throughout. (p-trend = 0.932). ACHD discharges have shown a significant and steady growth in number and complexity over the past 10 years representing a need for continued development of robust ACHD specialized care resources.