Department of Pediatrics, Division of Cardiology and Congenital Heart Surgery and Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, USA.
Am J Cardiol. 2011 Jul 15;108(2):290-3. doi: 10.1016/j.amjcard.2011.03.036. Epub 2011 May 3.
Atrial septal defect, ventricular septal defect (VSD), and atrioventricular septal defect (AVSD) are among the most common congenital heart lesions, with most children surviving to adulthood. However, the clinical course of these patients is largely unknown, particularly pertaining to inpatient care. The purpose of this study was to assess hospitalizations for septal defects in adults with congenital heart disease (CHD) and risk factors associated with significant morbidity and mortality. The 2007 Nationwide Inpatient Sample was used to assess national prevalence of hospitalizations in adults with CHD with septal defects. Co-morbidities and risk factors for mortality were also determined. There were 84,308 adult CHD admissions in the United States in 2007. Fifty-four percent of adult CHD admissions had diagnoses of septal defects, with 48% having atrial septal defect, 7% having VSD, and 0.4% having AVSD. Overall in-hospital mortality was 2.1%. Common co-morbidities included arrhythmias (31%), heart failure (20%), and diabetes mellitus (18%). On multivariable analysis, independent risk factors for mortality included presence of VSD (odds ratio 3.1, 95% confidence interval [CI] 1.5 to 6.5), trisomy 21 (odds ratio 2.9, 95% CI 1.1 to 7.5), and pulmonary hypertension (odds ratio 1.5, 95% CI 1.0 to 2.4). In conclusion, this study of hospitalizations in adults with septal defects found that admissions are common and associated with significant co-morbidities. Overall mortality is low but is increased in patients with VSD. Cardiac and noncardiac co-morbidities are commonly encountered. Many noncardiac conditions, including trisomy 21 and the youngest and oldest groups, are associated with an increased risk of death.
房间隔缺损、室间隔缺损（VSD）和房室间隔缺损（AVSD）是最常见的先天性心脏病病变之一，大多数患儿可存活至成年。然而，这些患者的临床过程在很大程度上是未知的，特别是关于住院治疗的情况。本研究旨在评估患有先天性心脏病（CHD）的成年人中因间隔缺损而住院的情况，以及与显著发病率和死亡率相关的危险因素。本研究使用了 2007 年全国住院患者样本，以评估美国患有 CHD 并伴有间隔缺损的成年人的住院率。还确定了与死亡率相关的合并症和危险因素。2007 年，美国有 84308 例成人 CHD 住院。54%的成人 CHD 住院患者被诊断患有间隔缺损，其中 48%为房间隔缺损，7%为 VSD，0.4%为 AVSD。总的院内死亡率为 2.1%。常见的合并症包括心律失常（31%）、心力衰竭（20%）和糖尿病（18%）。多变量分析显示，死亡率的独立危险因素包括 VSD 的存在（比值比 3.1，95%置信区间 [CI] 1.5 至 6.5）、21 三体（比值比 2.9，95%CI 1.1 至 7.5）和肺动脉高压（比值比 1.5，95%CI 1.0 至 2.4）。总之，这项关于间隔缺损成年人住院的研究发现，此类住院治疗较为常见，且与严重的合并症相关。总体死亡率较低，但 VSD 患者的死亡率增加。常见的心脏和非心脏合并症。许多非心脏疾病，包括 21 三体和年龄最小和最大的组，与死亡风险增加相关。
