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Hospitalizations Soar for CHD in Adult Patients


 

NEW ORLEANS — The annual number of hospitalizations for adults with congenital heart disease climbed by 71% in the United States between 1998 and 2005, far outstripping the 12% overall increase in hospital admissions among the general adult population.

Total hospital charges for adults with congenital heart disease (ACHD) skyrocketed from $1.1 billion in 1998 to $3.7 billion in 2005, a disproportionate increase relative to trends in the broader adult population. Indeed, this 229% jump in total charges was more than twice the rate of increase for all adult hospitalizations nationally during the same period, Dr. Alexander R. Opotowsky noted at the annual scientific sessions of the American Heart Association.

His analysis of data from the Hospital Cost and Utilization Project's Nationwide Inpatient Survey, the country's largest all-payer hospital discharge database, provided a first-ever look at national hospitalization trends for the growing ACHD population.

Hospitalizations for complex forms of ACHD rose by 58% during the study period, while admissions for simple diagnoses climbed by 129%, driven largely by a dramatic increase in admissions for patients with secundum atrial septal defect or patent foramen ovale, said Dr. Opotowsky of the University of Pennsylvania, Philadelphia.

Surgical as well as medical admissions increased, both in patients with simple as well as in those with complex forms of ACHD. Patients with simple forms of ACHD were slightly more likely than those with complex diagnoses to be admitted for surgery, mainly to address bicuspid aortic valves and aortic insufficiency, he continued.

Hospital admissions for electrophysiological diagnosis or procedures in ACHD patients increased by 98% during the study period. The annual number of hospitalizations for ACHD patients aged 55 or older increased by 78% between 1998 and 2005. The increase was 63% among 18- to 34-year-olds with ACHD and 67% in 35- to 54-year-olds.

“We now have an older, sicker population requiring more repeat admissions,” the cardiologist said.

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