Abstract 4146823: Trends and Outcomes in Heart Failure Admissions and Cardiogenic Shock Among Patients with Congenital Heart Disease

Introduction: This study examines trends in heart failure admissions, cardiogenic shock, mechanical circulatory support (MCS) usage, and cardiac transplant among patients with congenital heart disease (CHD), focusing on double (DV) and single ventricle (SV) CHD. Methods: We analyzed the national inpatient sample from 2016 to 2020 for heart failure admissions, including double and single ventricle CHD, and trends in cardiogenic shock, MCS utilization, cardiac transplants, and mortality. Results: Out of 4,963,884 total admissions, 29,805 were for DV-CHD and 2,415 for SV-CHD. Patients without CHD were older (mean age 71.5 years) than those with DV-CHD (mean age 59.8 years) and SV-CHD (mean age 17.9 years). Non-CHD patients had shorter stays (mean 5.8 days), and lower total charges. CHD admissions remained stable from 2016 to 2020. Cardiogenic shock rates were highest among SV-CHD patients, with significant fluctuations, followed by DV-CHD patients. MCS usage increased, particularly among SV-CHD patients, while DV-CHD patients showed an upward trend and patients without CHD had consistently lower usage. Heart transplant rates were low but increased slightly in 2020 for patients without CHD, with DV and SV CHD patients showing fluctuating rates peaking in 2018 and 2019, then declining in 2020. Inpatient mortality rates were highest among SV-CHD patients, followed by DV-CHD patients, both experiencing significant fluctuations and a general increasing trend, while patients without CHD had the lowest and most stable rates. Conclusion: Our analysis highlights trends in CHD management, including age, length of stay, mortality rates, and healthcare costs. Variations in cardiogenic shock, MCS usage, and cardiac transplants emphasize the need for adaptive clinical practices to optimize patient outcomes.