• J Billett, A Majeed, M Gatzoulis, and M Cowie.
• Imperial College London, Department of Primary Care and Social Medicine, Imperial College London, UK. juliebillett@yahoo.co.uk
• Heart. 2008 Mar 1;94(3):342-8.

ObjectiveTo ascertain time trends in rates of hospital admission, operations, in-hospital case fatality and general mortality for congenital heart disease (CHD) in England and Wales.DesignRetrospective analysis of Hospital Episodes Statistics for England (April 1995 to March 2004) and mortality statistics for England and Wales (1994-2003).PopulationAll NHS patients admitted with a primary diagnosis of CHD to hospitals in England, and all deaths in England and Wales with an underlying cause of CHD.Main Outcome MeasuresAge-standardised hospital admission rates, case fatality rates and death rates from congenital heart disease.ResultsBetween 1995/1996 and 2003/2004 the age-standardised hospital admission rate for CHD increased from 30.7 per 100,000 (95% CI 29.9 to 31.4) to 35.5 per 100,000 (95% CI 34.7 to 36.4) in men and boys and from 28.2 per 100,000 (95% CI 27.4 to 28.9) to 32.8 per 100,000 (95% CI 32.0 to 33.6) in women and girls. Between 1997/1998 and 2003/2004 in-hospital case fatality rates fell from 2.10% (95% CI 1.97 to 2.22) to 0.83% (95% CI 0.74 to 0.92). Population mortality fell steadily over the decade from 1994 to 2003 in men and women, with the largest proportionate decrease in the 1-4-year age group.ConclusionAdmission rates for CHD have increased over the past decade, particularly amongst patients in older age groups. There has also been a significant decrease in both in-hospital case fatality rates and in general population mortality rates. These trends are consistent with improvements in the quality of care for these patients, improvements in survival and the predicted expansion in the number of adults living with CHD.

24 keywords...

hide…