Hospital Utilization in Adults with Single Ventricle Congenital Heart Disease and Cardiac Arrhythmias
Article first published online: 21 OCT 2013
© 2013 Wiley Periodicals, Inc.
Journal of Cardiovascular Electrophysiology
Volume 25, Issue 2, pages 179–186, February 2014
How to Cite
COLLINS, R. T., FRAM, R. Y., TANG, X., ROBBINS, J. M. and ST. JOHN SUTTON, M. (2014), Hospital Utilization in Adults with Single Ventricle Congenital Heart Disease and Cardiac Arrhythmias. Journal of Cardiovascular Electrophysiology, 25: 179–186. doi: 10.1111/jce.12294
- Issue published online: 12 FEB 2014
- Article first published online: 21 OCT 2013
- Accepted manuscript online: 19 SEP 2013 07:30AM EST
- Manuscript Accepted: 13 SEP 2013
- Manuscript Revised: 5 SEP 2013
- Manuscript Received: 6 JUL 2013
- adult congenital heart disease;
- cardiac arrhythmia;
- healthcare cost;
- hospital utilization;
- single ventricle
Arrhythmia in Adults with Single Ventricles
The study sought to identify the impact of cardiac arrhythmias on hospitalizations in adults with single ventricle (SV) congenital heart disease (CHD).
Surgical advances have dramatically improved survival in patients with CHD. Cardiac arrhythmias and sudden cardiac death are common in adults with CHD.
Methods and Results
Data from 43 pediatric hospitals in the 2004 to 2011 Pediatric Health Information System database were used to identify patients ≥18 years of age admitted with International Classification of Diseases-9th Revision codes for a diagnosis of either hypoplastic left heart syndrome (HLHS), tricuspid atresia (TA) or common ventricle (CV), and a cardiac arrhythmia. Primary and secondary diagnoses, length of stay (LOS), hospital charges, and interventional procedures were determined. Multilevel models were used to evaluate differences in demographics, diagnoses, and clinical outcomes among the 3 subgroups (HLHS, TA, and CV). Interactions of charges with arrhythmia and admission year were examined using ANOVA. There were 642 admissions in 424 patients with SV CHD and an arrhythmia diagnosis. A single arrhythmia diagnosis was present in 454 admissions (71%). Total hospital charges were $80.7 million with mean charge per admission of $127,296 ± 243,094. The mean charge per hospital day was $16,653 ± 17,516 and increased across the study period (P < 0.01). Arrhythmia distributions were impacted by SV anatomic subtype (P < 0.001). Hospital resource utilization was significantly different among arrhythmia groups (P < 0.001).
In adults with SV CHD, arrhythmias are affected by SV anatomic subtype and impact adversely upon hospital resource utilization.