title: Nationwide Hospitalization Trends in Adult Congenital Heart Disease Across 2003-2012.
abstract: BACKGROUND
  We aimed to assess trends in hospitalization, outcomes, and resource utilization among patients admitted with adult congenital heart disease (ACHD).
  
  
  RESULTS
  We used the 2003-2012 US Nationwide Inpatient Sample for this study. All admissions with an ACHD were identified using standard ICD codes. Resource utilization was assessed using length of stay, invasive procedure utilization, and cost of hospitalization. There was a significant increase in the number of both simple (101%) as well as complex congenital heart disease (53%)-related admissions across 2003-2012. In addition, there was a considerable increase in the prevalence of traditional cardiovascular risk factors including older age, along with a higher prevalence of hypertension, diabetes, smoking, obesity, chronic kidney disease, and peripheral arterial disease. Besides miscellaneous causes, congestive heart failure (11.8%), valve disease (15.5%), and cerebrovascular accident (26.1%) were the top causes of admission to the hospital among patients with complex ACHD, simple ACHD without atrial septal defects/patent foramen ovale and simple atrial septal defects/patent foramen ovale patients, respectively. In-hospital mortality has been relatively constant among patients with complex ACHD as well as simple ACHD without atrial septal defects/patent foramen ovale. However, there has been considerable increase in the average length of stay and cost of hospitalization among the ACHD patients during 2003-2012.
  
  
  CONCLUSIONS
  There has been a progressive increase in ACHD admissions across 2003-2012 in the United States, with increasing healthcare resource utilization among these patients. Moreover, there has been a change in the cardiovascular comorbidities of these patients, adding a layer of complexity in management of ACHD patients.
authors.affiliation: Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH (S.A., K.S., V.M.).
authors.forename: Shikhar
authors.initials: S
authors.lastname: Agarwal
authors.affiliation: Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH (S.A., K.S., V.M.).
authors.forename: Karan
authors.initials: K
authors.lastname: Sud
authors.affiliation: Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH (S.A., K.S., V.M.).
authors.forename: Venu
authors.initials: V
authors.lastname: Menon
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006295:Health Resources / Q000706:statistics & numerical data / Q000639:trends; D006330:Heart Defects, Congenital / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000628:therapy*; D017721:Hospital Costs / Q000639:trends; D006760:Hospitalization / Q000191:economics / Q000639:trends*; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
keywords: adult congenital heart disease; cost of illness; hospital admission; length of stay; mortality; trends