Lesion-Based Patterns Of Morbidity And Mortality In Hospitalized Adolescents With Congenital Heart Disease

Objective: The objective of this analysis is to describe the characteristics and morbidity during hospitalizations among adolescents with congenital heart disease (AdoCHD) from the Pediatric Health Information System (PHIS) database. Methods: The PHIS database was queried for all AdoCHD admissions aged 12-18 years (1/1/2004-12/31/2013). Major forms of CHD were identified by their International Classification of Diseases, ninth revision codes, further verified based on their secondary diagnosis and/or procedure codes. Patient characteristics, diagnoses, procedures and vital status were assessed. Results: In total, there were 4,267 adolescents admitted to 42 Children's Hospitals, 58.3% were males, 24.6% single ventricle (SV) patients, 64.1% bi-ventricle (BV), and 11.3% could not be classified. They accounted for 8,512 hospitalizations (41,240 total hospital days), of which 31.6% were intensive care unit (ICU) stays. ICU stay was similar for the SV and BV patients with similar duration of mechanical ventilation between the two groups. Overall, the most common CHD among in-patients was tetralogy of Fallot (TOF, 36.4%). Larger proportion of the BV AdoCHD admissions were for elective surgical and electrophysiological procedures. There were 109 (2.5%) heart transplantations (1.3% SV vs. 0.6% BV) and 120 in-hospital deaths (2.8%) (1.1% SV vs. 1.3% BV). Hypoplastic left heart syndrome was the most common diagnosis in transplanted patients (46%) and those who died (28%); TOF (29%) was frequent in 91 (2.1%) patients who had cardiac arrests. Conclusions: Different hospitalization patterns exist for BV and SV AdoCHD. Recognizing this risk may encourage directing resources toward optimizing long-term care of CHD patients.