title: National database study of survival of pediatric congenital heart disease patients in Taiwan.
abstract: OBJECTIVE
  The incidence of congenital heart disease (CHD) and severe CHD is 13.08 and 1.51/1000 live births, respectively, in Taiwan, which has had national health insurance since 1995 and child health indices similar to those in the US. This study sought to further elucidate the fatality of CHD patients and their survival from a national database.
  
  
  METHODS
  From the national health insurance database 2000-2010, we retrieved data from CHD patients who were diagnosed at age <6 years. The survival status at discharge was ascertained for estimation of survival.
  
  
  RESULTS
  In total, 18,843 pediatric CHD patients were identified. The overall prevalence of CHD was 1288 per 100 000 live-births. Severe CHD (tetralogy of Fallot (4.4%), transposition of the great arteries (1.6%) and double outlet right ventricle (1.1%)) accounted for 11.5% of all cases. The 1-month/5-year survival in simple and severe CHD was 99.1%/97.5% and 90.2%/76.4%, respectively (p < 0.0001). The Kaplan-Meier survival at 5 years of age was lowest for hypoplastic left heart syndrome (19.7%), followed by transposition of the great arteries (66.7%), double outlet right ventricle (69.0%), and common ventricle (66.0%). The 5-year survival of the birth cohort in the same study period was 99.3%.
  
  
  CONCLUSIONS
  This national database study revealed that the survival of children with simple CHD was still slightly lower than that of the general population and the survival of severe CHD patients, though only accounting for one-tenth of CHD cases, remained unsatisfactory. Such survival profiles are similar to those from Western reports and warrant a refined and dedicated medical care program for children with CHD.
authors: Department of Pediatrics, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC; Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan, ROC.
authors: Shu-Jen
authors: SJ
authors: Yeh
authors: Genomics Research Center, Academia Sinica, Taipei City, Taiwan, ROC.
authors: Hui-Chi
authors: HC
authors: Chen
authors: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei City, Taiwan, ROC.
authors: Chun-Wei
authors: CW
authors: Lu
authors: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei City, Taiwan, ROC.
authors: Jou-Kou
authors: JK
authors: Wang
authors: Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan, ROC; Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei City, Taiwan, ROC.
authors: Li-Min
authors: LM
authors: Huang
authors: Taiwan Bureau of National Health Insurance, Taiwan, ROC.
authors: Shin-Chung
authors: SC
authors: Huang
authors: Taiwan Bureau of National Health Insurance, Taiwan, ROC.
authors: San-Kuei
authors: SK
authors: Huang
authors: Department of Pediatrics, National Taiwan University Hospital and Medical College, National Taiwan University, Taipei City, Taiwan, ROC. Electronic address: wumh@ntu.edu.tw.
authors: Mei-Hwan
authors: MH
authors: Wu
mesh_terms: D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006330:Heart Defects, Congenital / Q000145:classification* / Q000401:mortality*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D050498:Live Birth; D008297:Male; D009313:National Health Programs; D010372:Pediatrics; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology
keywords: Taiwan; congenital heart disease; mortality; national health insurance