Korean Circ J.  2015 Jan;45(1):59-66. 10.4070/kcj.2015.45.1.59.

Unscheduled Hospitalization in Adults with Congenital Heart Disease

• Negishi J
• Ohuchi H
• Yasuda K
• Miyazaki A
• Norifumi N
• Yamada O

• KMID: 2223847
• DOI: http://doi.org/10.4070/kcj.2015.45.1.59

Abstract

BACKGROUND AND OBJECTIVES
Little information is available regarding adult patients with congenital heart disease (CHD) who needed unscheduled hospitalization (USH). This paper aims to elucidate the clinical features of adult patients with CHD requiring USH.
SUBJECTS AND METHODS
Study subjects included patients with CHD aged 18 years or older who were hospitalized at our facility during a 5-year study period. Medical records were retrospectively reviewed and data regarding USH were collected. Patient's background, underlying heart disease, cause of hospitalization, and prognosis (second USH regardless of cause or death) were examined.
RESULTS
Overall, 959 CHD patients underwent a total of 1761 hospitalizations, including 145 patients who were unexpectedly hospitalized 239 times. The median age at USH was 27 years old. Of the 959 patients, 54% were male. Underlying heart diseases included repaired tetralogy of Fallot (21%), single ventricular physiology after Fontan operation (17%), and Eisenmenger syndrome (12%). The causes of USH included arrhythmia (40%), heart failure (20%), infectious disease (13%), and hemorrhage or thrombus (13%). A total of 48 patients required readmission. In total, 13 patients died, including four hospital deaths. The USH-free survival rate was 77% for 1 year and 58% for 3 years.
CONCLUSION
The rate of USH was high for adults with complicated CHD. Common causes of USH included arrhythmia, heart failure, hemorrhage-related or thrombus-related conditions and infection. These data provide the current status of medical care for adult CHD patients in Japan and their therapeutic needs.

Keyword

Heart defects, congenital; Hospitalization; Aging

MeSH Terms

Adult*
Aging
Arrhythmias, Cardiac
Communicable Diseases
Eisenmenger Complex
Fontan Procedure
Heart Defects, Congenital*
Heart Diseases
Heart Failure
Hemorrhage
Hospitalization*
Humans
Japan
Male
Medical Records
Physiology
Prognosis
Retrospective Studies
Survival Rate
Tetralogy of Fallot
Thrombosis

Figure

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  Fig. 1 The number of scheduled and unexpected hospitalizations from 2005 to 2009.

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  Fig. 2 Kaplan-Meier curve of survival after discharge.

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  Fig. 3 Kaplan-Meier curve of USH-free survival after discharge. USH: unscheduled hospitalization.

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  Fig. 4 Kaplan-Meier survival estimates for survival between simple CHD and complex CHD. CHD: congenital heart disease.

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  Fig. 5 Kaplan-Meier survival estimates for USH-free survival between simple CHD and complex CHD. USH: unscheduled hospitalization, CHD: congenital heart disease.

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