From the McGill Adult Unit for Congenital Heart Disease Excellence (A.J.M., R.I.-I., L.G., M.K.) and Division of Clinical Epidemiology (N.D.), McGill University Health Centre, Montreal, Canada; and Division of Cardiology, Stollery Children's Hospital and Department of Pediatrics, University of Alberta, Edmonton, Canada (A.S.M.).
Circulation. 2014 Aug 26;130(9):749-56. doi: 10.1161/CIRCULATIONAHA.113.008396. Epub 2014 Jun 18.
Our objective was to obtain contemporary lifetime estimates of congenital heart disease (CHD) prevalence using population-based data sources up to year 2010.
The Quebec CHD database contains 28 years of longitudinal data on all individuals with CHD from 1983 to 2010. Severe CHD was defined as tetralogy of Fallot, truncus arteriosus, transposition complexes, endocardial cushion defects, and univentricular hearts. We used latent class bayesian models combining case definitions from physician claims, hospitalization, and surgical data to obtain point and interval prevalence estimates of CHD in the first year of life, in children (<18 years of age) and in adults. We identified 107 559 CHD patients from 1983 to 2010. Prevalence of CHD in the first year of life was 8.21 per 1000 live births (95% confidence interval, 7.47-9.02) from 1998 to 2005. In 2010, overall prevalence of CHD was 13.11 per 1000 (95% confidence interval, 12.43-13.81) in children and 6.12 per 1000 (95% confidence interval, 5.69-6.57) in adults. CHD prevalence increased by 11% in children and 57% in adults from 2000 to 2010. Prevalence in the severe CHD subgroup increased by 19% (95% confidence interval, 17%-21%) in children and 55% (51%-62%) in adults. By 2010, adults accounted for 66% of the entire CHD population.
With an increase of >50% in CHD prevalence since 2000, by 2010 adults accounted for two thirds of patients with severe and other forms of CHD in the general population. Our findings should inform allocation of resources and the planning of workforce needs for the predominantly adult CHD population.
本研究旨在利用截至 2010 年的基于人群的数据资源，获得当前先天性心脏病（CHD）的终生患病率估计值。
魁北克 CHD 数据库包含 1983 年至 2010 年所有 CHD 患者 28 年的纵向数据。严重 CHD 定义为法洛四联症、动脉干畸形、心内膜垫缺损和单心室。我们使用基于病例定义的潜在类别贝叶斯模型，结合来自医生报告、住院和手术数据的病例定义，获得了 1 岁以内、儿童（<18 岁）和成人 CHD 的时点和区间患病率估计值。我们从 1983 年至 2010 年共发现 107559 例 CHD 患者。1998 年至 2005 年，1 岁以内 CHD 的患病率为 8.21/1000 活产儿（95%置信区间，7.47-9.02）。2010 年，儿童总体 CHD 的患病率为 13.11/1000（95%置信区间，12.43-13.81），成人患病率为 6.12/1000（95%置信区间，5.69-6.57）。2000 年至 2010 年，儿童 CHD 患病率增加 11%，成人增加 57%。儿童严重 CHD 亚组的患病率增加 19%（95%置信区间，17%-21%），成人增加 55%（51%-62%）。到 2010 年，成年人占所有 CHD 患者的 66%。
自 2000 年以来，CHD 患病率增加了>50%，到 2010 年，成年人占普通人群中严重和其他类型 CHD 患者的三分之二。我们的研究结果应该为资源配置和主要为成人 CHD 人群规划劳动力需求提供信息。
