Trends in patient characteristic, cost, and mortality among mechanically ventilated adult patients with congenital heart disease in the United States

Abstract Background There is an increasing number of adults with congenital heart disease (ACHD), but critically ill ACHD patients remain understudied. The objective of this study was to evaluate patient characteristics and trends in mortality of mechanically ventilated patients with ACHD. Methods We evaluated ACHD with an ICD-9 procedure code for mechanical ventilation using the National Inpatient Sample (NIS), a public all-payer inpatient United States database, from 2005-2014. Primary and secondary outcomes were evaluated using multivariable logistic regression. Results 10,962 of 77,334,704 discharges, representing 52,876 (0.6%) hospitalizations, were ACHD who required mechanical ventilation (MV). Mean age was 59 years (IQR 45-71), with 45.3% female. The number of ACHD requiring MV increased over the years (2,342 to 7,775, p Conclusion The number of mechanically ventilated ACHD has increased over the years. Remarkably, despite an increase in the age and comorbidity burden in this cohort, case-fatality ratio of these patients and the cost per patient remained stable. Nonetheless, there is a growing need for healthcare resources in the management of this cohort of patients. Further studies will need to be conducted to evaluate the underlying physiological impact and prognosis of MV in specific subsets of ACHD.