Pediatric Heart Failure Inpatient Mortality: A Cross-Sectional Analysis

Abstract

BackgroundHeart failure constitutes significant morbidity and mortality among the pediatric population. Few data exist on the prevalence and mortality rate of pediatric heart failure (pHF) in the United States. ObjectivesThis study aimed to determine the in-hospital mortality and the principal diagnoses in pediatric patients with heart failure who died while being hospitalized in the United States. MethodsThis is a retrospective cross-sectional study using data from the 2019 Kid Inpatient Database (KID). The KID contained data on hospitalized children below 21 years of age. Using Stata 17 software (StataCorp LLC, College Station, Texas), the data were searched for heart failure diagnoses using International Classification of Diseases 10th revision Clinical Modification (ICD-10-CM) codes. By using the "rank" command in Stata, the most common principal diagnoses were placed in descending order of frequency, and these were further divided into different ICD-10 code categories. ResultsThere were 16,206 pHF admissions in 2019. Of these admissions, 1,023 (6.31%) patients died. The top five principal ICD 10 code categories among all pHF deaths in descending order were circulatory system (17.95%), congenital/chromosomal abnormalities (17.43%), respiratory system (10.28%), infectious diseases (9.24%, and perinatal diseases (7.90%). Among all pHF deaths, sepsis of unspecified organisms (5.14%), hypoplastic left heart syndrome (HLHS) (3.19%), and acute respiratory failure with hypoxia (3.14%) were the most common primary diagnoses. Conclusion and significancePediatric heart failure in-hospital overall mortality is 6.31%, and sepsis of unspecified organisms, HLHS, and acute respiratory failure are the most common principal diagnoses among these children. Preventive measures and prompt treatment of infections are paramount to reducing pHF mortality.

Pediatric heart failure classification based on left ventricular ejection fraction

“…Studies in the United States have indicated that the in-hospital all-cause mortality of children with HF ranged from 6.3% to 7.4%, and many comorbid conditions, such as arrhythmia, pulmonary hypertension, sepsis, and renal failure are risk factors for in-hospital death. 3,24 Our study suggests that the all-cause mortality of children with HF was 9.9%. Sepsis, renal insufficiency, and abnormal E/A ratio are risk factors for inhospital mortality.…”

“…Owing to the frequent need for surgery or interventional therapy, the cost of HF in children is much higher than that in adults, which places a huge economic burden on society 2 . However, the global epidemiology, causes, treatment strategies, and outcomes of HF in children remain largely unknown, 3 and only data from local countries or regions have been reported. Studies have shown that the incidence of primary HF in children ranges from 0.87 per 100,000 (UK and Ireland) to 7.4 (Taiwan), and the prevalence of HF is approximately 83.3 per 100,000 (a large population‐based study in Spain) 4 …”

Burden of Renal Dysfunction and Neurologic Complications in Hospitalized Pediatric Heart Failure Unrelated to Congenital Heart Disease: A Multicenter Study

“…Interestingly, a study on hospitalized pHF patients from the 2019 Kid Inpatient Database (KID) showed that overall mortality was 6.31% in children aged <21 years, and there is a decreasing trend in mortality compared to the study by Rosanno et al, who noted a mortality rate of 7.3% among pHF admissions 10 years ago [4,31]. Sepsis of unspecified organisms, CHD (hypoplastic left heart syndrome), and acute respiratory failure are the most common principal diagnoses among hospitalized children with pHF.…”

Patients' prognosis with congenital heart disease followed by ten years: survival and associated factors

“…About 20 to 30% of patients with CHD who do not receive adequate treatment die in the first month of life due to heart failure and/or hypoxic crises, and about 50% die by the end of the first year of life. 3 – 5 …”

“…2 About 20 to 30% of patients with CHD who do not receive adequate treatment die in the first month of life due to heart failure and/or hypoxic crises, and about 50% die by the end of the first year of life. [3][4][5] Knowledge about the prognosis of CHD supports the obtaining of indicators related to good care practices and specific outcomes, such as death. This can provide better public policies aimed at this group of children, in addition to the best health services practices.…”