Abstract 13168: High Morbidities in Hospitalized Adolescents With Both Single and Biventricle Congenital Heart Disease

Abstract

Introduction: Quality of life in adolescents with single ventricle (SV) is known to be significantly impaired. In this study, we sought to quantify inpatient morbidities for single ventricle (SV) versus biventricle (BV) adolescents using data from the Pediatric Health Information System (PHIS). Methods: The PHIS database was queried for all admissions in adolescents aged 12-18 years (1/1/2004–12/31/2013) coded for CHD. Patients were categorized as SV or BV based on their primary and secondary ICD-9 diagnostic and/or procedure codes. Patient characteristics, diagnoses, procedures, vital status and standardized costs were examined. Results: 4,267 adolescents were admitted to 42 children’s hospitals over 10 years, accounting for 8,512 hospitalizations. Among patients, 24.6% were SV, 64.1% BV and 11.3% unclassifiable. Among hospitalizations, 29.5% were SV patients, 56.1% were BV patients, and 14.4% were unclassifiable. SV patients were more likely to have multiple hospitalizations than BV patients [51.0% vs 37.9%, p ≤ 0.001]. Mean age for adolescent admissions were similar for SV and BV hospitalizations [mean (SD) 15.0 (1.9) years vs 14.8 (1.9)]. Median lengths of stays (LOS) for BV hospitalizations were 2 days, [IQR 1-5] and 2 days [IQR 1-4] for SV hospitalizations, with a higher proportion of patients with LOS>2 days in the BV group [46.9%] than SV group [38.5%, p<0.001]. BV hospitalizations were more likely to entail ICU stays [36.6% vs 26.1%, p ≤0.001], to require mechanical ventilation [20.2% vs 8.8%, p ≤0.001] and had higher median total costs [$14,500, IQR $4140-$40,900 vs $8250, IQR $2,440-$23,300, p≤0.001]. There were no differences between SV and BV hospitalizations in use of one or more electrophysiological studies [16.4% vs 18.2%, p=0.062] or reporting of one or more tachyarrhythmias [7.5% vs 7.0%, p=0.505]. Procedure codes for pacemaker/intracardiac defibrillator were higher among SV hospitalizations [6.1% vs 4.1%, p≤0.001], as was an associated diagnosis of heart transplantation [2.3% vs 0.5%, p≤0.001]. Conclusions: Adolescents with CHD requiring hospitalizations are resource intensive irrespective of their CHD classification.