Epidemiology of Congenital Heart Disease in Kazakhstan: Data from the Unified National Electronic Healthcare System 2014-2021

Abstract

The aim of this study was to investigate the epidemiology of congenital heart disease (CHD) in Kazakhstan, using the data from the Unified National Electronic Healthcare System (UNEHS) for the period of 2014-2021. This retrospective cohort study included all patients diagnosed with CHD in Kazakhstan and registered in the UNEHS between January 2014 and December 2021. CHDs were defined based on ICD-10 codes Q20-Q26. Incidence, prevalence, and all-cause mortality rates were calculated per 100,000 population. Survival analysis was performed using Cox proportional hazards regression modeling and Kaplan-Meier method. The cohort consisted of 68,371 CHD patients, of whom 61,285 (89.6%) had a single CHD type, 40,767 (59.6%) were diagnosed before the age of 1 year, and 5,225 (7.6%) died over the study period. Incidence of CHD decreased from 64.6 to 47.3 cases per 100,000 population in males, and from 68.7 to 42.5 cases in females between 2014 and 2020. All-cause mortality rates per 100,000 population increased from 3.3 to 4.7 cases among males, and from 2.7 to 3.7 among females between 2014 and 2020. Survival analysis showed that in patients diagnosed with CHD before 1 year of age, risk of death was significantly associated with male sex (hazard ratio [HR] 1.17), multiple CHD types (HR 1.70), and no performed surgery (HR 0.57). In patients diagnosed with CHD after 1 year of age, risk factors were male sex (HR 1.65), multiple CHD types (HR 1.55), and no performed surgery (HR 1.82).