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. 2024 May;113(5):750-760.
doi: 10.1007/s00392-023-02370-6. Epub 2024 Mar 4.

Trends of mortality rate in patients with congenital heart defects in Germany-analysis of nationwide data of the Federal Statistical Office of Germany

Hashim Abdul-Khaliq  1   2 , Delphina Gomes  3 , Sascha Meyer  4 , Rüdiger von Kries  3 , Stefan Wagenpfeil  5 , Jochen Pfeifer  6 , Martin Poryo  6
Affiliations

Trends of mortality rate in patients with congenital heart defects in Germany-analysis of nationwide data of the Federal Statistical Office of Germany

Hashim Abdul-Khaliq et al. Clin Res Cardiol. 2024 May.

Abstract

Background: Congenital heart defects (CHD) are still associated with an increased morbidity and mortality. The aim of this study was to analyze trends of mortality rates in patients with CHD between 1998 and 2018 in Germany.

Methods: Data of registered deaths with an underlying diagnosis of CHD were used to evaluate annual mortality between 1998 and 2018. Polynomial regressions were performed to assess annual changes in CHD-associated mortality rates by age groups.

Results: During the 21-year study period, a total of 11,314 deaths were attributed to CHD with 50.9% of deaths in infants (age < 1 year) and 28.2% in neonates (age ≤ 28 days). The most frequent underlying CHDs associated with death were hypoplastic left heart syndrome (n = 1498, 13.2%), left ventricular outflow tract obstruction (n = 1009, 8.9%), atrial septal defects (n = 771, 6.8%), ventricular septal defects (n = 697, 6.2%), and tetralogy of Fallot (n = 673, 5.9%), and others (n = 6666, 58.9%). Among all patients, annual CHD-related mortality rates declined significantly between 1998 and 2010 (p < 0.0001), followed by a significant annual increase until 2018 (p < 0.0001). However, mortality rates in 2018 in all ages were significantly lower than in 1998.

Conclusion: Mortality in CHD patients decreased significantly between 1998 and 2010, but a substantial number of deaths still occurred and even significantly increased in the last 3 years of the observation period particularly in neonates and infants. This renewed slight increase in mortality rate during the last years was influenced mainly by high-risk neonates and infants. Assessment of factors influencing the mortality rate trends in association with CHD in Germany is urgently needed. Obligatory nationwide registration of death cases in relation to surgical and catheter interventions in CHD patients is necessary to provide additional valuable data on the outcome of CHD.

Keywords: Congenital heart defect; Infant; Mortality; Newborn.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Mean age of the deceased in years of age from 1998 to 2018. Data are depicted for “all diseases and sequelae of effects of external cause” as well as for “congenital malformations of the circulatory system” (ICD-10 code: Q20–Q28)
Fig. 2
Fig. 2
Annual mortality rates associated with any CHD in all ages. Black dots show observed mortality rate per year. Blue line shows the predicted mortality rate curve along with its 95% confidence interval based on a quadratic polynomial regression
Fig. 3
Fig. 3
Annual mortality rate associated with any CHD in infants (age < 1 year). Black dots show observed mortality rate per year. Blue line shows the predicted mortality rate curve along with its 95% confidence interval from a quadratic polynomial regression
Fig. 4
Fig. 4
Annual mortality rate associated with any CHD in persons aged 1 to 20 years. Black dots show observed mortality rate per year. Blue line shows the predicted mortality rate curve along with its 95% confidence interval from a quadratic polynomial regression
Fig. 5
Fig. 5
Annual mortality rate from hypoplastic left heart syndrome in persons aged 1 to 20 years. Black dots show observed mortality rate per year. Blue line shows the predicted mortality rate curve along with its 95% confidence interval from a linear regression
Fig. 6
Fig. 6
Annual mortality rates associated with any CHD for different age groups. Plots show real data fitted with smoothing method LOESS (locally estimated scatterplot smoothing)
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References

    1. Hoffman JIE, Hoffman JIE, Kaplan S, Kaplan S. The incidence of congenital heart disease. J Am Coll Cardiol. 2002;39:1890–1900. doi: 10.1016/S0735-1097(02)01886-7. - DOI - PubMed
    1. Schwedler G, Lindinger A, Lange PE, et al. Frequency and spectrum of congenital heart defects among live births in Germany. Clin Res Cardiol. 2011;100:1111–1117. doi: 10.1007/s00392-011-0355-7. - DOI - PubMed
    1. Lindinger A, Schwedler G, Hense H-W. Prevalence of congenital heart defects in newborns in Germany: results of the first registration year of the PAN Study (July 2006 to June 2007) Klin Padiatr. 2010;222:321–326. doi: 10.1055/s-0030-1254155. - DOI - PubMed
    1. van der Linde D, Konings EEM, Slager MA, et al. Birth prevalence of congenital heart disease worldwide. J Am Coll Cardiol. 2011;58:2241–2247. doi: 10.1016/j.jacc.2011.08.025. - DOI - PubMed
    1. Abu-Harb M, Hey E, Wren C. Death in infancy from unrecognised congenital heart disease. Arch Dis Child. 1994;71:3–7. doi: 10.1136/adc.71.1.3. - DOI - PMC - PubMed