Higher Cost of Hospitalizations for Non-cardiac Diagnoses in Adults with Congenital Heart Disease

Seckeler, Michael D.; Thomas, I. D.; Andrews, Jennifer; Meziab, Omar; Moe, Tabitha G.; Heller, Elissa; Klewer, Scott E.

doi:10.1007/s00246-017-1770-y

Cited by 21 publications

(20 citation statements)

References 17 publications

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“…30 Given the increasing numbers and ages of ACHD patients, the demand for healthcare will only increase. 4 , 10 , 33 , 34 Future studies are needed to develop specific pathways to optimize HF care in these patients such that comprehensive management is provided at every HF stage. 35 , 36 …”

Section: Discussionmentioning

confidence: 99%

Outcomes and healthcare resource utilization in adult congenital heart disease patients with heart failure

et al. 2021

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Aims While heart failure (HF) is a leading cause of death in adults with congenital heart disease (ACHD), few studies report contemporary outcomes after the first HF hospitalization. We examined outcomes of ACHD patients newly admitted for HF compared with ACHD patients without HF and the general HF population without ACHD. Methods and results Using population databases from a single-payer health system from 1994 to 2018, ACHD patients newly admitted for HF were matched 1:1 to ACHD patients without HF (n = 4030 matched pairs). Similarly, ACHD patients newly admitted for HF were matched 1:1 to HF patients without ACHD (n = 4336 matched pairs). Patients with ACHD and HF (median age 68 years, 45% women) experienced higher mortality in short-term [30 day adjusted hazard ratio (HR) 4.68, 95% confidence interval (CI) 4.06, 5.43,

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Section: Discussionmentioning

confidence: 99%

Outcomes and healthcare resource utilization in adult congenital heart disease patients with heart failure

et al. 2021

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“…Patients who have underlying cardiovascular conditions such as hypertension and coronary heart disease have additional morbidity and mortality for COVID-19 [ 2 , 3 ]. Patients with moderate and severe congenital heart disease (CHD) have empirically been considered higher risk from COVID-19 [ 3 , 4 ] though, due to their relatively small population, there are sparse data regarding the outcomes of hospitalized patients with moderate and severe CHD along with COVID-19. The purpose of this study was to use a national discharge database to analyze and report hospital outcomes for COVID-19 in the setting of moderate and severe CHD compared to those without CHD.…”

Section: Introductionmentioning

confidence: 99%

Worse Hospital Outcomes for Children and Adults with COVID-19 and Congenital Heart Disease

et al. 2021

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The aim of the current study is to investigate hospitalization outcomes of COVID-19 positive children and adults with moderate or severe congenital heart disease to children and adults without congenital heart disease. Retrospective review using the Vizient Clinical Data Base for admissions of patients with an ICD-10 code for COVID-19 from April 2020 to March 2021. Admissions with COVID-19 and with and without moderate or severe congenital heart disease (CHD) were stratified into pediatric (< 18 years) and adult (≥ 18 years) and hospital outcomes were compared. There were 9478 pediatric COVID-19 admissions, 160 (1.7%) with CHD, and 658,230 adult COVID-19 admissions, 389 (0.06%) with CHD. Pediatric admissions with COVID-19 and CHD were younger (1 vs 11 years), had longer length of stay (22 vs 6 days), higher complication rates (6.9 vs 1.1%), higher mortality rates (3.8, 0.8%), and higher costs ($54,619 vs 10,731; p < 0.001 for all). Adult admissions with COVID-19 and CHD were younger (53 vs 64 years, p < 0.001), had longer length of stay (12 vs 9 days, p < 0.001), higher complication rates (8 vs 4.8%, p = 0.003), and higher costs ($23,551 vs 13,311, p < 0.001). This appears to be the first study to report the increased hospital morbidities and costs for patients with CHD affected by COVID-19. Our hope is that these findings will help counsel patients moving forward during the pandemic.

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“…Seckeler and colleagues studied the cost of hospitalization for non-cardiac disease for adults with CHD. (15) They conducted a retrospective review of hospital discharge data from the University Health System Consortium Clinical Database from 2011 to 2013. They compared 9,169,700 adults without CHD to adults with differing severities of CHD.…”

Section: The Cost Of Chdmentioning

confidence: 99%

Selected 2018 Highlights in Congenital Cardiac Anesthesia

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Gottlieb

Adler

et al. 2019

Journal of Cardiothoracic and Vascular Anesthesia

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This article is a review of the highlights of pertinent literature published during the 12 months of 2017, which is of interest to the congenital cardiac anesthesiologist. Following a search of the US National Library of Medicine PubMed database, several topics emerged where significant contributions were made in 2017, and that the authors of this manuscript felt were noteworthy to be summarized in this review: Training in pediatric cardiac anesthesia, the costs of congenital heart disease (CHD), catheter versus surgical intervention for CHD, cerebral oxygen saturation in CHD, and mechanical circulatory support in children. Training in pediatric cardiac anesthesia In 2004, the Accreditation Council for Graduate Medical Education (ACGME) Next Accreditation system was implemented with the creation of milestones to all specialties.(1) Since 2007, for surgeons who operate on patients with CHD ranging from neonates to adults, a subspecialty certification in congenital cardiac surgery is granted following completion of a one-year accredited residency and passing of a written examination and an oral examination.(2) The number of accredited surgical programs in the US has increased from 2 in 2006 to 12, and the number of graduates has increased from 2 in 2008 to 44 in 2014.(3,4) Along with the increase in structured training for congenital cardiac surgery, there has been an increase in the need of physicians with advanced knowledge and experience in pediatric cardiac intensive care. Several informal advanced training pathways have been suggested following surgical, anesthesia or intensive care trainings and were discussed at the 10 th International Conference of the Pediatric Cardiac Intensive Care Society.(5) Similarly to surgical and intensive care specialties, pediatric cardiac anesthesiology has evolved as a subspecialty devoted to patients with CHD ranging from neonates to adults. While there is a consensus on the need to define standards for the pediatric cardiac anesthesia fellowship, there remains a wide variability in duration of training and clinical experience. Different training pathways have been proposed in the past few years and several recent publications are highlighted to outline the proposed future pathways. In Germany, a working group representing the German Society for Anesthesiology and Intensive Care surveyed all pediatric cardiac centers with the intent to define "expertise in pediatric cardiac anesthesia".(6) Twenty-seven centers with an active pediatric cardiac surgery program participated in the survey with a response rate of 96.3%. The suggested length of training in pediatric cardiac anesthesia was 12-months in 42.3% of centers with a mean of 10.8-months to achieve sufficient experience. However, the length of training may not be reflective of the competence of the trainee.(7) Because, different learners with different knowledge or experience backgrounds progress at different rates, the time needed by a trainee to achieve competence may vary.(8,9) Recently, based on the ACGME Milestones Model...

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Higher Cost of Hospitalizations for Non-cardiac Diagnoses in Adults with Congenital Heart Disease

Cited by 21 publications

References 17 publications

Outcomes and healthcare resource utilization in adult congenital heart disease patients with heart failure

Outcomes and healthcare resource utilization in adult congenital heart disease patients with heart failure

Worse Hospital Outcomes for Children and Adults with COVID-19 and Congenital Heart Disease

Selected 2018 Highlights in Congenital Cardiac Anesthesia

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