title: Outcomes of heart failure-related hospitalization in adults with congenital heart disease in the United States.
abstract: BACKGROUND
  Heart failure (HF) accounts for >3 million hospital admissions annually in adults with acquired cardiovascular disease, but there are limited data on HF admissions in adults with congenital heart disease (ACHD). The purpose of this study was to test the hypotheses that HF admissions are common in ACHD and associated with significant morbidity and mortality.
  
  
  METHODS
  The 2007 Nationwide Inpatient Sample was used to assess national prevalence, morbidities, and risk factors for mortality during hospitalizations among ACHD with HF.
  
  
  RESULTS
  Of the 84,308 (95% CI 71,345-97,272) ACHD admissions in the United States in 2007, 17,193 (95% CI 14,157-20,229) had a diagnosis of HF (20%). ACHD with HF was associated with an increased risk of death compared to ACHD without HF (OR 3.3, 95% CI 2.6-4.1). On multivariable analysis independent risk factors for mortality included nonoperative intubation (OR 6.1, 95% CI 3.3-11.4), sepsis (OR 4.3, 95% CI 2.4-7.4), and acute myocardial infarction (OR 3.2, 95% CI 1.8-5.7). Cardiac defects associated with an increased risk of mortality included ventricular septal defects (VSDs) (OR 1.8, 95% CI 1.0-3.4).
  
  
  CONCLUSIONS
  In this large population-based study, HF-related hospitalizations were common in ACHD and associated with an increased risk of death compared to non-HF admissions. The risk of mortality is increased with the diagnoses of VSDs and the presence of specific comorbidities such as respiratory failure and sepsis.
authors.affiliation: Baylor College of Medicine, Department of Pediatrics, Division of Cardiology and Congenital Heart Surgery, Houston, Tex, USA; Sibley Heart Center Cardiology and Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Fred H
authors.initials: FH
authors.lastname: Rodriguez
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Moodie
authors.forename: Dhaval R
authors.initials: DR
authors.lastname: Parekh
authors.forename: Wayne J
authors.initials: WJ
authors.lastname: Franklin
authors.forename: David L S
authors.initials: DL
authors.lastname: Morales
authors.forename: Farhan
authors.initials: F
authors.lastname: Zafar
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Adams
authors.forename: Richard A
authors.initials: RA
authors.lastname: Friedman
authors.forename: Joseph W
authors.initials: JW
authors.lastname: Rossano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D006333:Heart Failure / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult