Comparison of the epidemiology and co-morbidities of heart failure in the pediatric and adult populations: a retrospective, cross-sectional study

Gregory Webster,Jie Zhang,David Rosenthal

doi:10.1186/1471-2261-6-23

Abstract

BackgroundHeart failure is a clinical syndrome that is associated with a significant number of interventional procedures and has received a large amount of scrutiny in the adult literature; however, the epidemiology in children is less well described.MethodsWe analyzed two large, commercially available inpatient datasets collected in 1997 by the Agency for Healthcare Research and Quality: the Kids' Inpatient Database and the National Inpatient Study, accounting for 50% of the U.S. pediatric discharges and 20% of the U.S. adult discharges in 1997.ResultsThe database contained 5,610 children and 732,752 adults with a diagnosis of HF. When compared with the adult sample, the pediatric sample showed a higher proportion with cardiac procedures (61.4% vs. 0.28%, p < 0.01), a higher prevalence of congenital heart disease (61% versus 0.3%, p < 0.01), a higher percentage of male patients (50% pediatric vs. 44% adult, p < 0.01), and a lower percentage of white patients (40.9% vs. 65.6%, p < 0.01). Children had a significantly different spectrum of co-morbidities compared with adults. There was no difference in mortality rate between children and adults (7.5% vs. 7.9%, p = NS).ConclusionThere are significant differences in the epidemiological profile of children and adults with heart failure. Children suffer from different types of co-morbidities and require different procedures in the hospital setting. As such, children with heart failure who are hospitalized may require significantly different facilities, management and therapeutic intervention than adults with similar symptoms.

Highlights

Heart failure is a clinical syndrome that is associated with a significant number of interventional procedures and has received a large amount of scrutiny in the adult literature; the epidemiology in children is less well described
Previous studies in children such as the 1985 BaltimoreWashington Infant Study have described the incidence of congenital heart disease, but have not focused on heart failure [13]
The Prospective Pediatric Cardiomyopathy Registry reported on the incidence of pediatric cardiomyopathy in 2 regions of the United States, suggesting an incidence of 1.13 cases per 100,000 children [14]

Summary

Introduction

Heart failure is a clinical syndrome that is associated with a significant number of interventional procedures and has received a large amount of scrutiny in the adult literature; the epidemiology in children is less well described. Heart failure (HF) is a well-recognized clinical syndrome that affects both children and adults in the United States. The Framingham Heart Study has tracked data on adult cardiac disease since 1948 and numerous more recent trials have evaluated specific therapies for systolic dysfunction [1,2,3,4,5,6,7,8,9,10,11,12]. It is difficult to enroll large numbers of children in prospective studies, consent is more challenging (page number not for citation purposes). Other studies of pediatric HF or cardiomyopathy have had a limited sample size or have been from limited geographic regions [17,18,19]

Methods

Results

Conclusion