title: Emergency hospital admissions and three-year survival of adults with and without cardiovascular surgery for congenital cardiac disease.
abstract: OBJECTIVE
  This study determined the quantity and nature of emergencies leading to unscheduled hospital admissions of adults with congenital cardiac disease and their mid-term survival.
  
  
  RESULTS
  During 1 year, 429 adults with congenital cardiac diseases were admitted 571 times, and 124 admissions (22%) of 95 patients (22%) were emergency admissions. Fifteen of the 95 patients were seen for the first time in 1 of the participating centers. The underlying anomalies were Fallot's tetralogy and pulmonary atresia (n = 26/7), univentricular heart after Fontan procedure (n = 25), atrial septal defect (n = 18), Eisenmenger syndrome (n = 12), complete transposition (n = 11), and others (n = 25). Indications for admission were cardiovascular complications (n = 103; 83%) (arrhythmia, cardiac failure, syncope, pacemaker problems, pericardial tamponade, and sudden death), infections (n = 8, 6%) (endocarditis, pacemaker infection, pneumonia, and cerebral abscess), acute chest pain (n = 7; 6%), and acute abdominal pain (n = 4; 3%). All patients required immediate emergency care, and 16 patients (17%) required urgent cardiovascular or abdominal surgery. Six patients died during the hospital stay. During a follow-up of 2.9 years (SD 0.8), 16 (18%) of the discharged patients died, and 2 additional patients underwent heart or heart-lung transplantation.
  
  
  CONCLUSIONS
  Adults with congenital cardiac disease often experience serious emergency situations with a high in-hospital and mid-term post-hospital mortality. Care given by physicians with special expertise is important in this specific group of patients.
authors.affiliation: Deutsches Hertzentrum München, Department of Pediatric Cardiology and Congenital Heart Disease, Lazarettstrasse 36, D-80636 München, Germany. Kaemmerer@dhm.mhn.de
authors.forename: Harald
authors.initials: H
authors.lastname: Kaemmerer
authors.forename: Sohrab
authors.initials: S
authors.lastname: Fratz
authors.forename: Ulrike
authors.initials: U
authors.lastname: Bauer
authors.forename: Erwin
authors.initials: E
authors.lastname: Oechslin
authors.forename: Silke
authors.initials: S
authors.lastname: Brodherr-Heberlein
authors.forename: Bernhard
authors.initials: B
authors.lastname: Zrenner
authors.forename: Juraj
authors.initials: J
authors.lastname: Turina
authors.forename: Rolf
authors.initials: R
authors.lastname: Jenni
authors.forename: Peter E
authors.initials: PE
authors.lastname: Lange
authors.forename: John
authors.initials: J
authors.lastname: Hess
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000150:complications; D004630:Emergencies; D005500:Follow-Up Studies; D005858:Germany; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery; D006801:Humans; D010343:Patient Admission / Q000706:statistics & numerical data*; D015996:Survival Rate