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Epidemiology and cost of heart failure in children*

Published online by Cambridge University Press:  16 December 2015

Deipanjan Nandi*
Affiliation:
Cardiac Center, The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
Joseph W. Rossano
Affiliation:
Cardiac Center, The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
*
Correspondence to: Dr D. Nandi, MD, The Children’s Hospital of Philadelphia, 34th Street & Civic Center Boulevard, Philadelphia, PA 19104, United States of America. Tel: +267 432 2674; Fax: +215 590 5825; E-mail: nandid@email.chop.edu

Abstract

Heart failure in children is a complex disease process, which can occur secondary to a variety of aetiologies, including CHD, cardiomyopathy, or acquired conditions as well. Although the overall incidence of disease is low, the associated morbidity and mortality are high. Mortality may have decreased slightly over the last decade, and this is likely due to our ability to shepherd patients through longer periods of significant morbidity, with lasting effects. Costs of heart failure are significant – on the order of $1 billion annually as hospital charges for inpatient admissions alone. The value, or benefit to patient life and quality of life at this cost, is not well delineated. Further research is needed to optimise not only outcomes for these patients but also the high costs associated with them.

Type
Original Articles
Copyright
© Cambridge University Press 2015 

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Footnotes

*

Presented at the Children’s Hospital of Philadelphia Cardiology 2015: 18th Annual Update on Pediatric and Congenital Cardiovascular Disease: “Challenges and Dilemmas”, Scottsdale, Arizona, United States of America, Wednesday February 11, 2015 – Sunday, February 15, 2015.

References

1.Yancy, CW, Jessup, M, Bozkurt, B, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American college of cardiology foundation/American Heart Association Task Force on practice guidelines. Circulation 2013; 128: e240e327.Google Scholar
2.Law, SP, Kim, JJ, Decker, JA, et al. Hospital charges for pediatric heart transplant hospitalizations in the United States from 1997 to 2006. J Heart Lung Transplant 2012; 31: 485491.CrossRefGoogle ScholarPubMed
3.Dayton, JD, Kanter, KR, Vincent, RN, Mahle, WT. Cost-effectiveness of pediatric heart transplantation. J Heart Lung Transplant 2006; 25: 409415.CrossRefGoogle ScholarPubMed
4.O’Connor, MJ, Rossano, JW. Ventricular assist devices in children. Curr Opin Cardiol 2014; 29: 113121.CrossRefGoogle ScholarPubMed
5.Rossano, JW, Kim, JJ, Decker, JA, et al. Prevalence, morbidity, and mortality of heart failure-related hospitalizations in children in the United States: a population-based study. J Card Fail 2012; 18: 459470.CrossRefGoogle ScholarPubMed
6.Nandi, D, Lin, K, O’Connor, M, et al. Hospital Charges for Pediatric Heart Failure Related Hospitalization Admissions in the United States from 2000 to 2009. In Press, Pediatric Cardiology, 2015.CrossRefGoogle Scholar
7.Mozaffarian, D, Benjamin, EJ, Go, AS, et al. Heart disease and stroke statistics--2015 update: a report from the American Heart Association. Circulation 2015; 131: e29e322.Google ScholarPubMed
8.Heidenreich, PA, Albert, NM, Allen, LA, et al. Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail 2013; 6: 606619.CrossRefGoogle ScholarPubMed
9.Frankel, DS, Vasan, RS, D’Agostino, RB, et al. Resistin, adiponectin, and risk of heart failure. J Am Coll Cardiol 2009; 53: 754762.CrossRefGoogle ScholarPubMed
10.Damasceno, A, Mayosi, BM, Sani, M, et al. The causes, treatment, and outcome of acute heart failure in 1006 Africans from 9 countries. Arch Intern Med 2012; 172: 13861394.CrossRefGoogle ScholarPubMed
11.Rossano, JW, Shaddy, RE. Heart failure in children: etiology and treatment. J Pediatr 2014; 165: 228233.CrossRefGoogle ScholarPubMed
12.Massin, MM, Astadicko, I, Dessy, H. Epidemiology of heart failure in a tertiary pediatric center. Clin Cardiol 2008; 31: 388391.CrossRefGoogle Scholar
13.Rossano, JW, Goldberg, DJ, Mott, AR, et al. The burden of heart failure related hospitalizations in children with single ventricle heart disease in the United States (abstract). Circulation 2012; 126 (Suppl 21): A11975.Google Scholar
14.Lipshultz, SE, Sleeper, LA, Towbin, JA, et al. The incidence of pediatric cardiomyopathy in two regions of the United States. N Engl J Med 2003; 348: 16471655.CrossRefGoogle ScholarPubMed
15.Nugent, AW, Daubeney, PE, Chondros, P, et al. The epidemiology of childhood cardiomyopathy in Australia. N Engl J Med 2003; 348: 16391646.CrossRefGoogle ScholarPubMed
16.Andrews, RE, Fenton, MJ, Ridout, DA, Burch, M, British Congenital Cardiac Association. New-onset heart failure due to heart muscle disease in childhood: a prospective study in the United Kingdom and Ireland. Circulation 2008; 117: 7984.CrossRefGoogle ScholarPubMed
17.Wilkinson, JD, Landy, DC, Colan, SD, et al. The pediatric cardiomyopathy registry and heart failure: key results from the first 15 Years. Heart Fail Clin 2010; 6: 401413.CrossRefGoogle ScholarPubMed
18.Tsirka, AE, Trinkaus, K, Chen, SC, et al. Improved outcomes of pediatric dilated cardiomyopathy with utilization of heart transplantation. J Am Coll Cardiol 2004; 44: 391397.CrossRefGoogle ScholarPubMed
19.Maron, BJ, McKenna, WJ, Danielson, GK, et al. American College of Cardiology/European Society of Cardiology Clinical Expert consensus document on hypertrophic cardiomyopathy. J Am Coll Cardiol 2003; 42: 16871713.CrossRefGoogle Scholar
20.Colan, SD, Lipshultz, SE, Lowe, AM, et al. Epidemiology and cause-specific outcome of hypertrophic cardiomyopathy in children: findings from the Pediatric Cardiomyopathy Registry. Circulation 2007; 115: 773781.CrossRefGoogle ScholarPubMed
21.Webber, SA, Lipshultz, SE, Sleeper, LA, et al. Outcomes of restrictive cardiomyopathy in childhood and the influence of phenotype: a report from the Pediatric Cardiomyopathy Registry. Circulation 2012; 126: 12371244.CrossRefGoogle ScholarPubMed
22.Wouters, KA, Kremer, LCM, Miller, TL, Herman, EH, Lipshultz, SE. Protecting against anthracycline-induced myocardial damage: a review of the most promising strategies. Br J Haematol 2005; 131: 561578.CrossRefGoogle Scholar
23.Wittlieb-Weber, CA, Lin, KY, Zaoutis, TE, et al. Pediatric versus adult cardiomyopathy and heart failure–related hospitalizations: a value-based analysis. J Card Fail 2015; 21: 7682.CrossRefGoogle ScholarPubMed
24.Dipchand, AI, Edwards, LB, Kucheryavaya, AY, et al. The Registry of the International Society for Heart and Lung Transplantation: seventeenth official pediatric heart transplantation report-2014; focus theme: retransplantation. J Heart Lung Transplant 2014; 33: 985995.CrossRefGoogle ScholarPubMed
25.Towbin, JA, Lowe, AM, Colan, SD, et al. Incidence, causes, and outcomes of dilated cardiomyopathy in children. JAMA 2006; 296: 18671876.CrossRefGoogle ScholarPubMed
26.Alexander, PMA, Daubeney, PEF, Nugent, AW, et al. Long-term outcomes of dilated cardiomyopathy diagnosed during childhood: results from a national population-based study of childhood cardiomyopathy. Circulation 2013; 128: 20392046.CrossRefGoogle ScholarPubMed
27.Pahl, E, Sleeper, LA, Canter, CE, et al. Incidence of and risk factors for sudden cardiac death in children with dilated cardiomyopathy. J Am Coll Cardiol 2012; 59: 607615.CrossRefGoogle ScholarPubMed
28.Bharucha, T, Lee, KJ, Daubeney, PEF, et al. Sudden death in childhood cardiomyopathy. J Am Coll Cardiol 2015; 65: 23022310.CrossRefGoogle ScholarPubMed
29.Everitt, MD, Sleeper, LA, Lu, M, et al. Recovery of echocardiographic function in children with idiopathic dilated cardiomyopathy. J Am Coll Cardiol 2014; 63: 14051413.CrossRefGoogle ScholarPubMed
30.Shaddy, RE, Boucek, MM, Hsu, DT, et al. Carvedilol for children and adolescents with heart failure: a randomized controlled trial. JAMA 2007; 298: 11711179.CrossRefGoogle ScholarPubMed
31.Daubeney, PE, Nugent, AW, Chondros, P, et al. Clinical features and outcomes of childhood dilated cardiomyopathy: results from a national population-based study. Circulation 2006; 114: 26712678.CrossRefGoogle ScholarPubMed
32.O’Sullivan, JJ, Roche, SL, Crossland, DS, Chaudhari, MP, Kirk, RC, Asif, H. Recovery of heart function in children with acute severe heart failure. Transplantation 2008; 85: 975979.CrossRefGoogle ScholarPubMed
33.Lipshultz, SE, Orav, EJ, Wilkinson, JD, et al. Risk stratification at diagnosis for children with hypertrophic cardiomyopathy: an analysis of data from the Pediatric Cardiomyopathy Registry. Lancet 2013; 382: 18891897.CrossRefGoogle ScholarPubMed
34.Maron, BJ, Olivotto, I, Spirito, P, et al. Epidemiology of hypertrophic cardiomyopathy-related death: revisited in a large non-referral-based patient population. Circulation 2000; 102: 858864.CrossRefGoogle Scholar
35.Grupper, A, Park, SJ, Pereira, NL, et al. Role of ventricular assist therapy for patients with heart failure and restrictive physiology: improving outcomes for a lethal disease. J Heart Lung Transplant 2015; 34: 10421049.CrossRefGoogle Scholar
36.Hershberger, RE, Lindenfeld, J, Mestroni, L, et al. Genetic evaluation of cardiomyopathy – a heart failure society of America practice guideline. J Card Fail 2009; 15: 8397.CrossRefGoogle Scholar
37.Mahle, WT, Ianucci, G, Vincent, RN, Kanter, KR. Costs associated with ventricular assist device use in children. Ann Thorac Surg 2008; 86: 15921597.CrossRefGoogle ScholarPubMed
38.Mahle, WT, Forbess, JM, Kirshbom, PM, Cuadrado, AR, Simsic, JM, Kanter, KR. Cost-utility analysis of salvage cardiac extracorporeal membrane oxygenation in children. J Thorac Cardiovasc Surg 2005; 129: 10841090.CrossRefGoogle ScholarPubMed
39.Feingold, B, Arora, G, Webber, SA, Smith, KJ. Cost-effectiveness of implantable cardioverter-defibrillators in children with dilated cardiomyopathy. J Card Fail 2010; 16: 734741.CrossRefGoogle ScholarPubMed
40.Porter, ME. What is value in health care? N Engl J Med 2010; 363: 24772481.CrossRefGoogle ScholarPubMed
42.Drucker, NA, Colan, SD, Lewis, AB, et al. Gamma-globulin treatment of acute myocarditis in the pediatric population. Circulation 1994; 89: 252257.CrossRefGoogle ScholarPubMed
43.Isogai, T, Yasunaga, H, Matsui, H, Tanaka, H, Horiguchi, H, Fushimi, K. Effect of intravenous immunoglobulin for fulminant myocarditis on in-hospital mortality: propensity score analyses. J Card Fail 2015; 21: 391397.CrossRefGoogle ScholarPubMed
44.Hartman, ME, Linde-Zwirble, WT, Angus, DC, Watson, RS. Trends in the epidemiology of pediatric severe sepsis. Pediatr Crit Care Med 2013; 14: 686693.CrossRefGoogle ScholarPubMed