Determinants of outpatient clinic attendance amongst adults with congenital heart disease and outcome

Kempny, Aleksander; Diller, Gerhard‐Paul; Dimopoulos, Konstantinos; Alonso‐Gonzalez, Rafael; Uebing, Anselm; Li, Wei; Babu‐Narayan, Sonya V.; Swan, Lorna; Wort, Stephen J.; Gatzoulis, Michael Α.

doi:10.1016/j.ijcard.2015.10.081

Cited by 80 publications

(103 citation statements)

References 41 publications

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“…In a single-center report of 4461 adult patients with congenital heart defects with 48 828 patient-years of follow-up, missed appointments and delay in care were predictors of mortality. 54 …”

Section: Congenital Cardiovascular Defects and Kawasaki Diseasementioning

confidence: 99%

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Benjamin¹,

Blaha²,

Chiuve³

et al. 2017

Circulation

7,606

5,040

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Section: Congenital Cardiovascular Defects and Kawasaki Diseasementioning

confidence: 99%

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Benjamin¹,

Blaha²,

Chiuve³

et al. 2017

Circulation

7,606

5,040

View full text Add to dashboard Cite

“…The following types of mortality were analysed: in‐hospital (n = 10), infant (<1 year, n = 6), neonatal (<28 days, n = 2), postoperative (n = 2), post‐discharge (n = 3), intra‐stage (n = 2), and long‐term (>1 year, n = 6) (see Table for study‐specific definitions). Four measures of SES were reported in the included studies: area‐based poverty (n = 13), parental (maternal or paternal) or area‐based education (n = 9), individual health insurance status (n = 8), and area‐based income (n = 8) . The definitions for SES measures used in individual studies are given in Table .…”

Section: Resultsmentioning

confidence: 99%

“…The definitions for SES measures used in individual studies are given in Table . The included articles were based on US (n = 22), UK (n = 5), and Panama (n = 1) populations. Most articles included all CHD subtypes combined (n = 21), with the rest including cases of HLH or single ventricle (SV) defects (n = 5), atrioventricular septal defect (AVSD, n = 1), and a composite group of “critical” subtypes (n = 1) .…”

Section: Resultsmentioning

confidence: 99%

Socio‐economic inequalities in mortality in children with congenital heart disease: A systematic review and meta‐analysis

Best

Vieira

Glinianaia

et al. 2019

Paediatric Perinatal Epid

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Background The impact of socio‐economic status (SES) on congenital heart disease (CHD)‐related mortality in children is not well established. Objectives We aimed to systematically review and appraise the existing evidence on the association between SES (including poverty, parental education, health insurance, and income) and mortality among children with CHD. Data sources Seven electronic databases (Medline, Embase, Scopus, PsycINFO, CINAHL, ProQuest Natural, and Biological Science Collections), reference lists, citations, and key journals were searched. Study selection and data extraction We included articles reporting original research on the association between SES and mortality in children with CHD if they were full papers published in the English language and regardless of (a) timing of mortality; (b) individual or area‐based measures of SES; (c) CHD subtype; (d) age at ascertainment; (e) study period examined. Screening for eligibility, data extraction, and quality appraisal were performed in duplicate. Synthesis Meta‐analyses were performed to estimate pooled ORs for in‐hospital mortality according to health insurance status. Results Of 1388 identified articles, 28 met the inclusion criteria. Increased area‐based poverty was associated with increased odds/risk of postoperative (n = 1), neonatal (n = 1), post‐discharge (n = 1), infant (n = 1), and long‐term mortality (n = 2). Higher parental education was associated with decreased odds/risk of neonatal (n = 1) and infant mortality (n = 5), but not with long‐term mortality (n = 1). A meta‐analysis of four US articles showed increased unadjusted odds of in‐hospital mortality in those with government/public versus private health insurance (OR 1.40, 95% CI 1.24, 1.56). The association between area‐based income and CHD‐related mortality was conflicting, with three of eight articles reporting significant associations. Conclusion This systematic review provides evidence that children of lower SES are at increased risk of CHD‐related mortality. As these children are over‐represented in the CHD population, interventions targeting socio‐economic inequalities could have a large impact on improving CHD survival.

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“…Adherence to scheduled clinic care was associated with better survival independent of age and disease complexity among adult CHD patients for one clinic in London (28). Among a cohort of over 70,000 adults with CHD in Quebec, care in specialized ACHD centers was associated with reduced odds of death, most primarily among patients with CCHD (29).…”

Section: Discussionmentioning

confidence: 99%

How often is congenital heart disease recognized as a significant comorbidity among hospitalized adults with congenital heart disease?

Robbins

Onukwube

Goudie

et al. 2017

International Journal of Cardiology

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Background Despite frequent life-long hemodynamic and electrophysiologic abnormalities, adults with congenital heart defects (CHDs) are often lost to medical follow-up. Using a cohort of adults with CHD receiving hospital care in Arkansas, we sought to determine how often a CHD is recognized and coded during hospital admissions. Methods Data for this study come from the Agency for Healthcare Research and Quality’s Arkansas State Inpatient Database (SID) for years 2004 to 2012. Using unique identifiers that link patients across hospitalizations, we created a cohort of 3,973 patients ≥18 years old with an ICD-9 code for a CHD diagnosis noted at discharge during any hospitalization. Results These 3,973 patients had 19,638 hospitalizations. A CHD was listed as the principal diagnosis in 3% of hospitalizations, a secondary diagnosis in 22%, and no CHD was listed in 75% of hospitalizations. Among patients with a critical CHD, no critical CHD was noted in 69% of hospitalizations. Cardiovascular events (heart failure, arrhythmias, cerebrovascular accidents, embolic event, or death) occurred in 60% of hospitalizations of critical CHD patients wherein no critical CHD was recorded. Conclusions CHDs are rarely acknowledged during hospitalizations of adults with a known CHD even when cardiovascular events occur. Improved awareness, disclosure and attention to comorbid CHDs among patients and providers may improve hospital management and outcomes of cardiovascular events.

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Determinants of outpatient clinic attendance amongst adults with congenital heart disease and outcome

Cited by 80 publications

References 41 publications

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association

Socio‐economic inequalities in mortality in children with congenital heart disease: A systematic review and meta‐analysis

How often is congenital heart disease recognized as a significant comorbidity among hospitalized adults with congenital heart disease?

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