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Revision: review of non-elective hospitalisations of adults with CHD

Published online by Cambridge University Press:  10 July 2017

Alexandra Soufi ,
Jack M. Colman ,
Qunyu Li ,
Erwin N. Oechslin  and
Adrienne H. Kovacs
Alexandra Soufi
Affiliation:
Cardio-Pediatric and Congenital Medico-Surgical Department, Cardiologic Hospital Louis Pradel, Lyon, France Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada
Jack M. Colman
Affiliation:
Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada
Qunyu Li
Affiliation:
Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada
Erwin N. Oechslin
Affiliation:
Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada
Adrienne H. Kovacs*
Affiliation:
Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, Canada
*
Correspondence to: A. H. Kovacs, PhD, Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network, 585 University Avenue, 5N-519, Toronto, ON, Canada, M5G 2N2. Tel: 416 340 4871; Fax: 416 340 5014; E-mail: akovacs@uhnresearch.ca
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Abstract

Introduction

The adult CHD population is increasing and ageing and remains at high risk for morbidity and mortality. In a retrospective single-centre study, we conducted a comprehensive review of non-elective hospitalisations of adults with CHD and explored factors associated with length of stay.

Methods

We identified adults (⩾18 years) with CHD admitted during a 12-month period and managed by the adult CHD service. Data regarding demographics, cardiac history, hospital admission, resource utilisation, and length of stay were extracted.

Results

There were 103 admissions of 91 patients (age 37±10 years; 52% female). Of 91 patients, 96% had moderate or complex defects. Of 103 admissions, 45% were through the emergency department. The most common reasons for admission were arrhythmia (37%) and heart failure (28%); 29% of admissions included a stay in the ICU. The mean number of consultations by other services was 2.0. Electrophysiology and anaesthesiology departments were most frequently consulted. After removing outliers, the mean length of stay was 7.9±7.4 days (median=5 days). The length of stay was longer for patients admitted for heart failure (12.2±10.3 days; p=0.001) and admitted directly to the ward (9.6±8.9 days; p=0.009).

Conclusions

Among non-electively hospitalised adults with CHD in a tertiary-care centre, management often entails an interdisciplinary approach, and the length of stay is longest for patients admitted with heart failure. The healthcare system must ensure optimal resources to maintain high-quality care for this expanding patient population.

Keywords

Adult CHDhospitalisationheart failurelength of stay
Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Issue 9 , November 2017 , pp. 1764 - 1770
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Copyright
© Cambridge University Press 2017 

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