Abstract 18459: Outcomes of Pediatric Heart Failure Related Hospitalizations in Canada:2004-2013
Introduction: Heart failure (HF) in children is an important cause of morbidity and mortality with frequent hospitalizations. We sought to describe the prevalence, causes and outcomes of heart failure hospitalizations (HFH) in Canada during a contemporary 10-year time frame and compare the Canadian experience with the U.S experience.
Methods: All HFH with heart failure as a primary or secondary diagnosis between 2004 and 2013 in patients <18 years of age in Canada were identified using the Discharge Abstract Database (DAD) of the Canadian Institute of Health information (CIHI).
Results: A total of 4,693 HFH occurred among 3,523 children, with annual number of hospitalizations ranging from 435 to 559 (7-10 HFH/100,000 children). Infants were the most commonly affected age group (73.6% of all admissions). Congenital heart disease (CHD), cardiomyopathy, and acquired heart disease were associated with 76.1%, 10.5% and 4.2% of HFH respectively. Ventricular septal defect was the most common CHD lesion (33%). Median length of stay (LOS) for all HFH was 10.7 days (IQR 4.1 - 28.7) and was highest in the 0-30 day age group at 21.7 days (IQR 8.1 - 46.6). The in-hospital mortality rate was 8.8%, with the majority of deaths occurring during the index hospitalization. Extra-corporeal life support (ECLS), ventricular assist-device implantation (VAD) and cardiac transplantation occurred in 2.4%, 0.7% and 1.9% respectively. 31.5% of HFH had cardiac surgery and/or catheterization. For patients discharged alive, the cumulative 30-day readmission rate was 12.5%.
Conclusions: Pediatric HFHs in Canada are a high-risk event with a significant risk for death and early readmission after discharge. Canadian data shares some similarities with that of the U.S with few pertinent differences. Infants remain the most commonly affected group with CHD seen in the majority of the HFH. ECLS, VAD and cardiac transplant including crude hospital mortality rates are similar in both jurisdictions. HFH rates are lower in Canada as compared to U.S (7-10 v/s 14.5-17.9 per 100,000 children/year). Over the ten-year study period, the annual hospitalization rate has declined significantly in Canada by 3% per year, which differs from the United States where the hospitalizations have remained constant.
Author Disclosures: G.P. Mansukhani: None. S. Islam: None. A.S. Mackie: None. P. Kaul: None. P.F. Kantor: None.
- © 2016 by American Heart Association, Inc.