Mercado Amelia E, Well Andrew, Lamari-Fisher Alexandra, Mizrahi Michelle, Johnson Gregory, Patt Hanoch, Fraser Charles D, Mery Carlos M, Beckerman Ziv
Texas Center for Pediatric and Congenital Heart Disease, UT Health Austin and Dell Children's Medical Center, USA.
University of Texas at Austin Dell Medical School, USA.
Int J Cardiol Congenit Heart Dis. 2022 Feb 2;7:100340. doi: 10.1016/j.ijcchd.2022.100340. eCollection 2022 Mar.
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.
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).
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.
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.
患有先天性心脏病的成年人（ACHD）面临心理挑战。此外，ACHD患者的心理健康障碍（MHD）未得到充分认识。了解MHD对ACHD住院治疗的影响可能会为重新设计ACHD护理模式提供更好的信息并有所帮助。
对德克萨斯州住院患者出院数据集（TIDD）进行回顾性研究。查询了从2009年初到2018年底的十年期间的数据。利用ICD-9/10诊断代码识别ACHD出院病例以及十二种不同的MHD。记录了人口统计学特征和结果。使用美国心脏病学会（ACC）/美国心脏协会（AHA）病变严重程度评分系统（LSS）对先天性心脏病进行分类。
共识别出10515例符合条件的出院病例，其中1643例（15.6%）至少有一种MHD。与没有心理健康、焦虑或抑郁诊断的患者相比，发现有这些诊断的患者存在人口统计学差异。与没有MHD的ACHD患者相比，患有MHD的患者住院时间更长（分别为5[3-8]天和4[2-7]天，p<0.001）。与没有焦虑或抑郁诊断的患者相比，有这些诊断的患者存在LSS差异。在调整人口统计学变量后，LSS 3与心理健康、焦虑或抑郁诊断相关。在调整人口统计学变量和LSS后，住院时间延长也与心理健康、焦虑或抑郁诊断相关。
这些发现凸显了在ACHD护理模式中进行心理健康评估的必要性。进一步的研究应在考虑心理健康护理的情况下分析ACHD的最佳护理方式。
