National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Mail Stop E-86, 1600 Clifton Rd, Atlanta, GA 30333, USA.
Circulation. 2010 Nov 30;122(22):2254-63. doi: 10.1161/CIRCULATIONAHA.110.947002. Epub 2010 Nov 22.
Previous reports suggest that mortality resulting from congenital heart disease (CHD) among infants and young children has been decreasing. There is little population-based information on CHD mortality trends and patterns among older children and adults.
We used data from death certificates filed in the United States from 1999 to 2006 to calculate annual CHD mortality by age at death, race-ethnicity, and sex. To calculate mortality rates for individuals ≥1 year of age, population counts from the US Census were used in the denominator; for infant mortality, live birth counts were used. From 1999 to 2006, there were 41,494 CHD-related deaths and 27,960 deaths resulting from CHD (age-standardized mortality rates, 1.78 and 1.20 per 100,000, respectively). During this period, mortality resulting from CHD declined 24.1% overall. Mortality resulting from CHD significantly declined among all race-ethnicities studied. However, disparities persisted; overall and among infants, mortality resulting from CHD was consistently higher among non-Hispanic blacks compared with non-Hispanic whites. Infant mortality accounted for 48.1% of all mortality resulting from CHD; among those who survived the first year of life, 76.1% of deaths occurred during adulthood (≥18 years of age).
CHD mortality continued to decline among both children and adults; however, differences between race-ethnicities persisted. A large proportion of CHD-related mortality occurred during infancy, although significant CHD mortality occurred during adulthood, indicating the need for adult CHD specialty management.
先前的报告表明，婴儿和幼儿因先天性心脏病（CHD）导致的死亡率一直在下降。但对于年龄较大的儿童和成年人的 CHD 死亡率趋势和模式，基于人群的信息很少。
我们使用了美国 1999 年至 2006 年期间死亡证明的数据，按死亡时的年龄、种族和性别计算了 CHD 死亡率的年度变化。为了计算年龄在 1 岁以上人群的死亡率，我们在分母中使用了美国人口普查的人口计数；对于婴儿死亡率，我们使用了活产计数。1999 年至 2006 年，共有 41494 例 CHD 相关死亡和 27960 例 CHD 死亡（标准化死亡率分别为每 10 万人 1.78 和 1.20）。在此期间，CHD 死亡率总体下降了 24.1%。所有研究种族的 CHD 死亡率均显著下降。然而，差距仍然存在；非西班牙裔黑人和非西班牙裔白人之间的死亡率差异始终存在，无论是总体水平还是婴儿水平。婴儿死亡率占 CHD 总死亡率的 48.1%；在存活至 1 岁的人群中，76.1%的死亡发生在成年期（≥18 岁）。
儿童和成人的 CHD 死亡率持续下降；然而，种族差异仍然存在。尽管在成年期发生了显著的 CHD 死亡率，但大部分 CHD 相关死亡率发生在婴儿期，这表明需要进行成人 CHD 专科管理。
