Mortality, morbidity increased with heart failure hospitalization in adults with congenital heart disease

For adults with congenital heart disease (ACHD), those with heart failure (HF) hospitalizations have an increased risk for mortality and morbidity, according to a study published in the Dec. 5 issue of the Journal of the American Heart Association.

Pradyumna Agasthi, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues compared the outcomes of HF versus non-HF hospitalizations in ACHD. Predictors of 90-day and one-year mortality were determined, and the risks for mortality, major adverse cardiac and cerebrovascular events, and health resource use were quantified.

Data were included for 26,454 unique ACHD admissions between Jan. 1, 2010, and Dec. 31, 2020; 22 and 78 percent were hospitalized with and without HF, respectively. The researchers observed an increase from 6.6 to 10.4 percent in ACHDHF hospitalizations. During a mean follow-up of 2.23 ± 2.19 years, patients with ACHDHF hospitalizations had increased risks for mortality, major adverse cardiac and cerebrovascular events, and health resource use, including rehospitalization (hazard ratios, 1.86, 1.73, and 1.09, respectively) and increased postacute care service use (hazard ratio, 1.56). Lower 90-day and one-year mortality were seen in association with cardiology clinic visits within 30 days of hospital admission (odds ratios, 0.62 and 0.69, respectively).

"Young adults living with CHD in the United States are at increased risk of death and cardiovascular complications following hospitalization for HF," the authors write. "Those engaged in cardiology care before hospitalization have lower mortality risk, reinforcing the importance of specialist care for achieving optimal health outcomes among adults living with CHD."

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