Emergency hospital admissions and three-year survival of adults with and without cardiovascular surgery for congenital cardiac disease.
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.
Kaemmerer
Harald
H
Deutsches Hertzentrum München, Department of Pediatric Cardiology and Congenital Heart Disease, Lazarettstrasse 36, D-80636 München, Germany. Kaemmerer@dhm.mhn.de
Fratz
Sohrab
S
Bauer
Ulrike
U
Oechslin
Erwin
E
Brodherr-Heberlein
Silke
S
Zrenner
Bernhard
B
Turina
Juraj
J
Jenni
Rolf
R
Lange
Peter E
PE
Hess
John
J
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