Morbidity, mortality up for youth with CHD presenting to ED

(HealthDay)—Children with congenital heart disease (CHD) presenting to the emergency department have increased rates of inpatient admission and mortality and higher emergency department charges than those without CHD, according to a study published in the Oct. 9 issue of the Journal of the American College of Cardiology.

Jonathan B. Edelson, M.D., from the Children’s Hospital of Philadelphia, and colleagues describe national estimates of pediatric CHD-related emergency department visits in an epidemiological analysis of emergency department visit-level data. Data were included for 420,452 CHD-related emergency department visits.

The CHD emergency department visits accounted for 0.17 percent of all pediatric emergency department visits. The researchers found that those with CHD had an increased likelihood of being younger than 1 year (43 versus 13 percent) and having one or more complex chronic conditions (35 versus 2 percent). The rates of inpatient admission (46 versus 4 percent; adjusted odds ratio, 1.89), median emergency department charges ($1,266 versus $741), and mortality rate (1 versus 0.04 percent; adjusted odds ratio, 1.25) were higher for CHD-related emergency department visits. During the nine-year study period, the adjusted median charges increased from $1,219 to $1,630, while there was a decrease in the mortality rate from 1.13 to 0.75 percent for CHD-related emergency department visits.

“Children with CHD presenting to the emergency department represent a medically complex population at increased risk for morbidity, mortality, and resource utilization compared with those without CHD,” the authors write.

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