• Fred H Rodriguez, Douglas S Moodie, Dhaval R Parekh, Wayne J Franklin, David L S Morales, Farhan Zafar, Gerald J Adams, Richard A Friedman, and Joseph W Rossano.
• Baylor College of Medicine, Department of Pediatrics, Division of Cardiology and Congenital Heart Surgery, Houston, Tex, USA; Sibley Heart Center Cardiology and Emory University School of Medicine, Atlanta, GA, USA.
• Congenit Heart Dis. 2013 Nov 1;8(6):513-9.

BackgroundHeart failure (HF) accounts for >3 million hospital admissions annually in adults with acquired cardiovascular disease, but there are limited data on HF admissions in adults with congenital heart disease (ACHD). The purpose of this study was to test the hypotheses that HF admissions are common in ACHD and associated with significant morbidity and mortality.MethodsThe 2007 Nationwide Inpatient Sample was used to assess national prevalence, morbidities, and risk factors for mortality during hospitalizations among ACHD with HF.ResultsOf the 84,308 (95% CI 71,345-97,272) ACHD admissions in the United States in 2007, 17,193 (95% CI 14,157-20,229) had a diagnosis of HF (20%). ACHD with HF was associated with an increased risk of death compared to ACHD without HF (OR 3.3, 95% CI 2.6-4.1). On multivariable analysis independent risk factors for mortality included nonoperative intubation (OR 6.1, 95% CI 3.3-11.4), sepsis (OR 4.3, 95% CI 2.4-7.4), and acute myocardial infarction (OR 3.2, 95% CI 1.8-5.7). Cardiac defects associated with an increased risk of mortality included ventricular septal defects (VSDs) (OR 1.8, 95% CI 1.0-3.4).ConclusionsIn this large population-based study, HF-related hospitalizations were common in ACHD and associated with an increased risk of death compared to non-HF admissions. The risk of mortality is increased with the diagnoses of VSDs and the presence of specific comorbidities such as respiratory failure and sepsis.© 2012 Wiley Periodicals, Inc.

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