Abstract 10919: Contemporary Life Expectancy and Standardized Mortality of Adult Survivors With Congenital Heart Lesions
Background: Survival beyond the age of 18 years in patients born with congenital heart disease (CHD) is now near 90% but contemporary estimates of outcome in adult survivors are lacking.
Methods: In a prospective cohort of 3,334 adults with CHD followed up to 24 years in a single tertiary centre median age of survival (MAS) was estimated by computing left-truncated and right-censored Kaplan-Meier curves with age as time scale. Standardized mortality ratio (SMR) was also determined using one-sample log-rank test from age at diagnosis-, sex- and time of follow-up-adjusted death rates of general population in Spain. Patients were classified into 3 groups according to CHD complexity: I, simple (1,647); II, moderate (1,283); and III, severe (404). For mortality analysis, data provided by the Spanish national death index were used.
Results: There were 1,688 males and 1,646 females. Median age at first examination was 22 years (IQR 18-39) and median follow-up time 10.6 years (1-18). At the end of the study 336 patients had died (prevalence 10%; annual incidence 0.89%). Estimated MAS was 78.0 years (95% CI 76-82) for group I; 72,1 years (68-78) for group II; and 51.1 years (48-53) for group III (p<0.001). MAS was older than 75 years in all diagnostic categories in group I; between 60 and 75 years (moderate reduction) in subvalvular aortic stenosis, Ebstein anomaly, coarctation of the aorta, tetralogy of Fallot and complete transposition; and < 60 years (severe reduction) in Eisenmenger syndrome, single ventricle, AV discordance and pulmonary atresia The SMR was 1.66 (1.4-2.5) for the group I; 3.27 (2.6-4.1) for the group II; and 20.4 (10-26) for the group III (p<0.001 in all, compared to reference population). The SMRs for main individual diagnostic categories are shown in figure.
Conclusion: Life expectancy for CHD adults is reduced proportionally to complexity of the heart defect. Data for individual diagnostic categories might be used as a prognostic index.
Author Disclosures: J.M. Oliver: None. P. Gallego: None. A.E. Gonzalez Garcia: None. D. Garcia Hamilton: None. R. Yotti: None. I. Ferreira Gonzalez: None. F. Fernandez Aviles: None.
- © 2015 by American Heart Association, Inc.