Mental health diagnoses in hospitalized adults with congenital heart disease in the state of Texas: A 10-year review.

BACKGROUND

Adults with congenital heart disease (ACHD) face psychological challenges. Furthermore, ACHD patients experience an under-recognition of mental health disorders (MHD). Understanding the impact of MHDs on ACHD hospitalizations may better inform and help re-design the ACHD care model.

METHODS

A retrospective review of the Texas Inpatient Discharge Dataset (TIDD) was performed. Data was queried across a ten-year period, from the beginning of 2009 to the end of 2018. ACHD discharges as well as twelve different MHD were identified utilizing ICD-9/10 diagnostic codes. Demographic characteristics and outcomes were recorded. CHD were classified using the American College of Cardiology (ACC)/American Heart Association (AHA) lesion severity score system (LSS).

RESULTS

A total of 10,515 eligible discharges were identified, of which 1643(15.6%) had at least one MHD. Demographic differences were found for those with a mental health, anxiety, or depression diagnosis when compared to those without. ACHD patients with MHD had a longer length of stay (LOS) compared to those without (5 [3-8] vs. 4 [2-7] days, p < 0.001). LSS differences were found for patients with an anxiety or depression diagnosis when compared to those without. After adjusting for demographic variables, a LSS 3 was associated with a mental health, anxiety, or depression diagnosis. After adjusting for demographic variables and LSS, a longer LOS was also associated with a mental health, anxiety, or depression diagnosis.

CONCLUSIONS

These findings highlight the need for mental health evaluation within the ACHD care model. Further research should analyze optimum care delivery for ACHD with mental health care in mind.