Trends in Hospitalizations for Adults With Congenital Heart Disease in the U.S.

Objectives: The purpose of this study was to better define the epidemiology of hospitalizations for adults with congenital heart disease (ACHD) in the U.S. Background: There is a growing population of ACHD as the result of advances in pediatric care and diagnostic testing. Methods: We used nationally representative data from the 1998 to 2005 Nationwide Inpatient Sample to identify patients ≥18 years of age admitted to an acute care hospital with an International Classification of Diseases-9th Revision code designating a CHD diagnosis. National estimates of hospitalizations and total hospital charges by year were calculated. Results: The number of ACHD hospitalizations increased 101.9% from 35,992 ± 2,645 in 1998 to 72,656 ± 5,258 in 2005. During this period, the annual number of admissions grew for both simple (19,448 ± 1,614 to 44,707 ± 3,644) and complex (12,507 ± 1,172 to 19,973 ± 1,624) diagnoses. The percentage of admissions originating in the emergency department (41.7 ± 0.8%) or involving cardiac surgery (17.7 ± 0.7%) remained stable during the study period. The average patient age (52.3 ± 0.8 years to 53.8 ± 0.6 years, p < 0.0001) and proportion of patients with ≥2 medical comorbidities (23.3 ± 0.9% to 33.0 ± 0.7%, p < 0.0001) increased. Mean hospital charges per hospitalization increased 127% from $19,186 ± $803 to $43,496 ± $2,166, and the estimated total national charges for these hospitalizations increased 357% from $691 million in 1998 to $3.16 billion in 2005 (in inflation-adjusted 2005 dollars). Conclusions: The number of hospital admissions for ACHD in the U.S. more than doubled between 1998 and 2005. Hospital charges attributable to these admissions have grown even more dramatically. [Copyright &y& Elsevier]