The following is a summary of “Mortality and Morbidity of Heart Failure Hospitalization in Adult Patients With Congenital Heart Disease,” published in the November 2023 issue of Cardiology by Agasthi et al.

Limited information exists regarding the outcomes subsequent to heart failure (HF) hospitalization among adults grappling with congenital heart disease (CHD) in the United States. Their objective was to assess and contrast the outcomes between hospitalizations due to HF and those not related to HF among adults dealing with CHD.

Employing a national deidentified administrative claims dataset, the researchers delved into the hospitalizations of patients with adult congenital heart disease (ACHD), distinguishing between those hospitalized with and without HF (designated as ACHDHF+ and ACHDHF−, respectively). The investigators sought to identify predictors of 90-day and 1-year mortality while quantifying the risk of mortality, major adverse cardiac and cerebrovascular events, and healthcare resource utilization. The study group compared ACHDHF+ versus ACHDHF− concerning event risks and healthcare resource utilization through Cox proportional hazard regression. Among 26,454 unique ACHD admissions recorded between January 1, 2010, and December 31, 2020, 5,826 (22%) were categorized as ACHDHF+, while 20,628 (78%) were designated ACHDHF−. Interestingly, the prevalence of ACHD HF+ hospitalizations notably increased from 6.6% to 14.0% during the study period (P<0.0001). Over an average follow-up period of 2.23 ± 2.19 years, patients with ACHDHF+ exhibited a heightened risk of mortality (hazard ratio [HR], 1.86 [95% CI, 1.67–2.07], P<0.001), major adverse cardiac and cerebrovascular events (HR, 1.73 [95% CI, 1.63–1.83], P<0.001), and amplified healthcare resource utilization, including rehospitalization (HR, 1.09 [95% CI, 1.05–1.14], P<0.001) and escalated postacute care service usage (HR, 1.56 [95% CI, 1.32–1.85], P<0.001). Notably, cardiology clinic visits within 30 days of hospital admission were associated with decreased 90-day and 1-year all-cause mortality risks (odds ratio [OR], 0.62 [95% CI, 0.49–0.78], P<0.001; OR, 0.69 [95% CI, 0.58–0.83], P<0.001, respectively).

In conclusion, HF-related hospitalizations in individuals with ACHD are linked to heightened risks of mortality and morbidity, accompanied by extensive healthcare resource utilization. However, recent attendance at cardiology clinics appears to mitigate these risks.

Source: ahajournals.org/doi/10.1161/JAHA.123.030649