As surgical and medical outcomes of children with congenital heart disease improve, it is expected that the pediatric population with heart failure (HF) will increase. To describe the characteristics and inpatient outcomes of HF patients across USA Type of study: Retrospective cohort study Database: Pediatric Health Information System Study period: January 2004 - December 2017 Inclusion criteria: All HF ICD 9/10 codes in patients ≤ 21 y/o from 50 different hospitals across USA

1. PURPOSE
Epidemiology of Pediatric Heart Failure in the US
•Type of study: Retrospective cohort study
•Database: Pediatric Health Information System
Study period: January 2004 - December 2017
•Inclusion criteria: All HF ICD 9/10 codes in
patients ≤ 21 y/o from 50 different hospitals
across USA
BACKGROUND
METHODS
To describe the characteristics and inpatient
outcomes of HF patients across USA
CONCLUSION
As surgical and medical outcomes of children
with congenital heart disease improve, it is
expected that the pediatric population with heart
failure (HF) will increase.
Table 1:Demographics Table 3:Variables related to inpatient mortality
•Pediatric HF admissions have increased, and
they were more frequent in infants patients and
in those with congenital heart disease
•Multiple medical and surgical factors were
statistically significantly associated with
inpatient mortality
REFERENCES
1. Rossano JW, Kim JJ, Decker JA, Price JF, Zafar F, Graves DE, et al. Prevalence,
morbidity, and mortality of heart failure-related hospitalizations in children in the
United States: a population-based study. Journal of cardiac failure. 2012;18(6):459-70
Raysa Morales-Demori, MD; Marc Anders, MD
Section of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Texas Children’s Hospital
Table 2:Outcomes
RESULTS
Total, N, (%)
76,646
Age in months, median
(IQR 25-75)
7.2
(2.1-68.1)
Male, N (%) 39,856 (52%)
Race/ethnicity
White Non-Hispanics 36,024 (47%)
Hispanics 16,096 (21%)
African American 9,964 (13%)
Others 8,431 (11%)
Risk of mortality
Minor 5,365 (7%)
Moderate 26,060 (34%)
Major 31,425 (41%)
Extreme 13,796 (18%)
ICU admission, N (%) 59,784 (78%)
TPN, N (%) 25,293 (33%)
Infection, N (%) 33,724 (44%)
Malignancy, N (%) 3,066 (4%)
Congenital heart disease, N (%) 57,570 (75%)
Total, N, (%)
76,646
Invasive ventilation, N (%) 46,143 (60%)
Hospital LOS in days, median
(IQR 25-75)
10
(5-27)
Overall mortality, N (%) 6,132 (8%)
ICU LOS in days, median
(IQR 25-75)
3
(0-11)
ICU mortality, N (%) 7,665 (10%)
Medical complication, N (%) 1,073 (1.4%)
Surgical procedure, N (%) 42,155 (55%)
Surgical complication, N (%) 22,342 (53%)
Pre-surgical LOS in days,
median (IQR 25-75)
1
(0-5)
Post-surgical LOS in days,
median (IQR 25-75)
9
(4-22)
ECMO, N (%) 4,563 (6%)
VAD, N (%) 964 (1%)
Heart transplantation, N (%) 2,872 (4%)
Billed charges in US$,
median (IQR 25-75)
151,049
(58,400-404,836)
OR (CI 95%)
White Non-Hispanics 0.78 (0.75-0.83)**
Heart transplantation 0.61 (0.52-0.72)**
Congenital heart
disease
0.61 (0.57-0.64)**
Risk of mortality:
Minor
Moderate
Major
0.03 (0.02-0.05)**
0.07 (0.06-0.08)**
0.57 (0.54-0.61)**
Extreme 12.46 (11.78-13.18)**
ECMO 11.20 (10.48-11.96)**
Invasive ventilation 6.39 (5.70-7.20)**
TPN use 5.93 (5.60-6.27)**
VAD placement 3.56 (3.06-4.14)**
Malignancy 2.70 (2.45-2.97)**
Infection 2.68 (2.54-2.83)**
Medical complication 2.33 (1.99-2.73)**
Surgical procedure 1.72 (1.61-1.85)◊
Surgical complication 1.50 (1.43-1.58)**
ICU admission 1.44 (1.36-1.53)◊
Figure 1: HF admissions and mortality trend Figure 2: VAD procedure and heart transplantation trend
◊ significant by univariate analysis only
** significant by univariate and multivariate analysis
7,359
(1.24%)
p < 0.0001 p < 0.00016,708
(1.15%)
3,504
(0.86%)