For a study, researchers sought to describe the current prevalence of primary and concomitant pediatric HF in the United States. HF patients and comorbidities were identified using the International Classification of Diseases, Clinical Modification codes from the Kids’ Inpatient Database, National Inpatient Sample, National Emergency Department (ED) Sample, and National Vital Statistics System between 2012 and 2016. All visits/events among pediatric and adult individuals were included in the study to describe HF occurrences. HF incidents were categorized into one of three categories: no heart failure, primary heart failure, or comorbid heart failure. Investigators compared patients with and without HF and computed unique incident rates after adjusting for age and gender.
Most juvenile HF-related ED visits and hospitalizations were caused by congenital heart disease, conduction disorders/arrhythmias, and cardiomyopathy. In 2016, comorbid HF ED visits increased (rate ratio: 1.93; P=0.001), as did primary HF hospitalizations (rate ratio: 1.14; P=0.002). The burden of pediatric heart failure was lower than that of adult heart failure; nonetheless, mortality in the emergency department and the hospital were much higher in children with HF than in adults.
The prevalence of pediatric HF was rising. Children hospitalized with HF had worse outcomes and spent more resources per patient than adults with HF who arrived at the ED and stayed in the hospital. National endeavors to better understand risk factors for morbidity and mortality in juvenile heart failure, as well as ongoing surveillance and reduction of avoidable risk factors, may help slow this upward trend.