Analysis of adults with congenital heart disease presenting to pediatric emergency departments with arrhythmias.
Congenit Heart Dis
; 12(4): 507-511, 2017 Jul.
Article
em En
| MEDLINE
| ID: mdl-28544787
ABSTRACT
OBJECTIVE:
As survivors of congenital heart disease (CHD) continue to age, healthcare utilization by this population has increased. It is unknown how often these patients utilize the emergency department (ED) at children's hospitals and how arrhythmias play a role in their utilization of care.DESIGN:
Using a retrospective cohort design, the Pediatric Hospital Information System (PHIS) database was investigated and we studied adults (≥18 years) with CHD (ACHD) who presented to pediatric EDs from 2004 to 2014.SETTING:
Tertiary care pediatric hospitals.RESULTS:
Of the 6310 encounters to pediatric EDs, 1594 (25%) were for arrhythmias. The median age was 21 years (IQR 19.1-25.1). The most common tachyarrhythmia diagnoses during the study period were atrial flutter (32%), atrial fibrillation (15%), and paroxysmal VT (10%). Bradyarrhythmias represented a minority of total arrhythmias. Presentation with arrhythmias was associated with an increased risk of admission, ICU care, and death (P < .01). Arrhythmias are also highly associated with CHD severity with twice as many complex CHD having arrhythmias compared to simple CHD (P < .01).CONCLUSIONS:
Total admissions of adults with CHD from the ED of children's hospitals have increased over time while the transfers to outside facilities remain consistently low. While the population of ACHD continues to grow, utilization of pediatric EDs for this cohort has increased. Adults with higher CHD complexity are more likely to present with clinical arrhythmias but there is a growing number of ACHD patients with simple complexity presenting with arrhythmias in recent years. ACHD patients that present with arrhythmias are at increased risk of morbidity and mortality.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Arritmias Cardíacas
/
Serviço Hospitalar de Emergência
/
Centros de Atenção Terciária
/
Cardiopatias Congênitas
/
Hospitalização
/
Hospitais Pediátricos
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Congenit Heart Dis
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Estados Unidos