Predicting 10-year mortality in adults with congenital heart disease

Abstract

Background: Advances 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. Methods: In this single center study, we administered a survey to patients ≥18 years of age with CHD to assess their 10-year mortality risk. Results: A 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%. Conclusions: In 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.

Keywords

• Adult congenital heart disease
• Congenital heart disease
• Mortality
• Co-morbidities