Seckeler Michael D, Thomas Ian D, Andrews Jennifer, Meziab Omar, Moe Tabitha, Heller Elissa, Klewer Scott E
Department of Pediatrics (Cardiology), University of Arizona, 1501 N. Campbell Ave, PO Box 245073, Tucson, AZ, 85724, USA.
Department of Pediatrics, University of Arizona, Tucson, AZ, USA.
Pediatr Cardiol. 2018 Mar;39(3):437-444. doi: 10.1007/s00246-017-1770-y. Epub 2017 Nov 15.
Adults with congenital heart disease (CHD) are a rapidly increasing population and their impact on healthcare resources is not fully understood. The purpose of this study was to describe the costs of hospitalizations for non-cardiac disease for adults with CHD. We conducted a retrospective review of hospital discharge data from the University HealthSystem Consortium Clinical Data Base/Resource Manager from January 2011 through December 2013. Patients were ≥ 18 years old at admission with any ICD-9 code for moderate or high severity CHD; cardiac surgical admissions were excluded. The comparison group consisted of patients ≥ 18 years old with no ICD-9 codes for any severity CHD. There were 9,169,700 non-CHD, 28,224 moderate CHD, and 3045 high severity CHD hospital admissions. Total length of stay was longer for acute kidney injury, depressive disorder, esophageal reflux, and obstructive sleep apnea for any severity CHD; ICU admission rates were higher for all diagnoses with any severity CHD. Mean observed direct costs were higher for all diagnoses for moderate CHD and all diagnoses except dehydration, type 2 diabetes, obesity, and obstructive sleep apnea for high severity CHD. This review identified significantly increased hospitalization costs for adults with moderate and high severity CHD who are admitted for non-cardiac medical conditions not associated with concomitant cardiac surgical procedures. Admissions with CHD diagnoses had higher ICU admission rates, longer lengths of stay, and higher mortality for most non-cardiac admission diagnoses. These data will add to our understanding of the economic impact of adults with CHD.
患有先天性心脏病（CHD）的成年人数量正在迅速增加，但其对医疗资源的影响尚未得到充分了解。本研究的目的是描述患有CHD的成年人因非心脏疾病住院的费用。我们对2011年1月至2013年12月大学卫生系统联盟临床数据库/资源管理器中的医院出院数据进行了回顾性分析。入院时年龄≥18岁且有任何中度或高度严重程度CHD的ICD-9编码的患者；排除心脏外科手术入院患者。对照组由年龄≥18岁且无任何严重程度CHD的ICD-9编码的患者组成。共有9169700例非CHD、28224例中度CHD和3045例高度严重程度CHD的住院病例。对于任何严重程度的CHD，急性肾损伤、抑郁症、食管反流和阻塞性睡眠呼吸暂停的总住院时间更长；任何严重程度的CHD所有诊断的重症监护病房（ICU）入住率更高。中度CHD所有诊断的平均观察到的直接费用更高，高度严重程度CHD除脱水、2型糖尿病、肥胖和阻塞性睡眠呼吸暂停外所有诊断的平均观察到的直接费用更高。本综述发现，因与心脏外科手术无关的非心脏疾病入院的中度和高度严重程度CHD成年人的住院费用显著增加。患有CHD诊断的入院患者在大多数非心脏入院诊断中ICU入住率更高、住院时间更长且死亡率更高。这些数据将增进我们对患有CHD的成年人的经济影响的理解。
