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. 2022 Oct 1;150(4):e2022056294.
doi: 10.1542/peds.2022-056294.

Lesion-Specific Congenital Heart Disease Mortality Trends in Children: 1999 to 2017

Melodie M Lynn  1   2 , Jason L Salemi  3   4 , Stefan P Kostelyna  2 , Shaine A Morris  1 , S Kristen Sexson Tejtel  1 , Keila N Lopez  1
Affiliations

Lesion-Specific Congenital Heart Disease Mortality Trends in Children: 1999 to 2017

Melodie M Lynn et al. Pediatrics. .

Abstract

Objective: Congenital heart disease (CHD) is a leading cause of premature death in infants and children. Currently limited data are available regarding lesion specific mortality over time. Our study aimed to describe pediatric mortality trends by CHD lesion in the United States.

Methods: We conducted a 19 year analysis (1999 to 2017) of publicly available, deidentified multiple cause of death data compiled and produced by the National Center for Health Statistics. Analysis was stratified by CHD diagnosis and age using 3 age categories (infants, 1 to 4 years, and 5 to 17 years). Temporal trends of CHD mortality and the effect of contributing risk factors were analyzed by using joinpoint regression.

Results: Mortality was highest for in infants for all CHD lesions, in particular for total anomalous pulmonary venous return. Significant declines in infant CHD mortality occurred for most other lesions. Contributing risk factors, including prematurity, extracardiac birth defects, and genetic conditions, occurred in 19% of infant CHD deaths and demonstrated worse mortality trends in the majority of lesions. Mortality rates remained highest for single ventricle lesions in all ages, with an infant mortality rate plateau in the later half of the study and progressive increasing mortality rates for children 5 to 17 years.

Conclusions: CHD mortality is decreasing for most lesions. Because of the heterogenicity of CHD lesions, there is expected variability in mortality trends by lesion and age group. Single ventricle lesions continue to contribute most heavily to premature death because of CHD demonstrated by significant increases in mortality rate for children aged 5 to 17 years.

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Conflict of interest statement

CONFLICT OF INTEREST DISCLOSURES: The authors have no conflict of interest relevant to this article to disclose.

Figures

FIGURE 1
FIGURE 1
Joinpoint infant mortality for different congenital heart disease lesions from 1999 to 2017. Specific congenital heart disease temporal mortality. The black line represents the APC of lesions including contributing risk factors. The blue line represents the APC of lesions excluding contributing risk factors. Contributing risk factors include prematurity, extracardiac birth defects, and/or genetic conditions listed as a contributing cause of death.
FIGURE 2
FIGURE 2
Joinpoint single ventricle mortality from 1999 to 2017. Single ventricle temporal mortality stratified by age group. Infant mortality rate calculated per 100 000 live births. Mortality rates for decedents >1 year of age calculated per 100 000 persons on the basis of the population of that age. The black line represents the APC of lesions including contributing risk factors. The blue line represents the APC of lesions excluding contributing risk factors. Contributing risk factors include prematurity, extracardiac birth defects, and/or genetic conditions listed as a contributing cause of death.
FIGURE 3
FIGURE 3
Joinpoint tetralogy of Fallot mortality from 1999 to 2017. Tetralogy of Fallot temporal mortality stratified by age group. Infant mortality rate calculated per 100 000 live births. Mortality rates for decedents >1 year of age calculated per 100 000 persons on the basis of the population of that age. The black line represents the annual percent change (APC) of lesions including contributing risk factors. The blue line represents the APC of lesions excluding contributing risk factors. Contributing risk factors include prematurity, extra cardiac birth defects, and/or genetic conditions listed as a contributing cause of death.
See this image and copyright information in PMC

References

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