Predicting 10-year mortality in adults with congenital heart disease

Abstract

BackgroundAdvances in the management of patients with congenital heart disease (CHD) have made survival to adulthood an expectation. Although the literature is limited, existing evidence suggests that adult co-morbidities may be at least as prevalent in patients with CHD, if not more so, than in an age-matched general population. The presence of these co-morbidities in combination with underlying CHD likely places these patients at increased risk for early mortality. Thus, we sought to determine the predicted 10-year mortality risk in a cohort of adults with CHD. MethodsIn this single center study, we administered a survey to patients ≥18 years of age with CHD to assess their 10-year mortality risk. ResultsA total of 406 patients agreed to participate. The median age was 41.8 ± 15.3 years, and 58% were female. The average predicted 10-year mortality for the CHD cohort was 13.7 ± 15.8%. For CHD patients ≥50 years of age, the average 10-year mortality risk was 29.8 ± 3.0% compared to 26.1% ± 0.2% in the general population (p < 0.001). Patient with CHD of great complexity had the highest predicted mortality risk at 53.0 ± 7.7%. ConclusionsIn this study examining 10-year mortality risk in adults with CHD, we demonstrated that predicted mortality for CHD patients is higher than the general population with complex patients having the highest predicted 10-year mortality. This tool may provide useful information in clinical decision making. A multi-center approach to validate this tool in the CHD population appears warranted, with broader consideration of CHD-targeted variables.