Projected growth of the adult congenital heart disease population in the United States to 2050: an integrative systems modeling approach

Population Health Metrics

Research

Karen Stout¹  Elisa Zaragoza-Macias¹  Catherine P. Benziger²  Amelia Bertozzi-Villa³  Abraham D. Flaxman³ 

[1] Department of Cardiology, University of Washington, Seattle, WA, USA;Department of Medicine, University of Washington, Seattle, WA, USA;Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA;

关键词: Heart defects;    Congenital;    Mortality;    Vital statistics;    Survival;    Population;   

DOI  :  10.1186/s12963-015-0063-z

 received in 2014-09-23, accepted in 2015-10-09,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundMortality for children with congenital heart disease (CHD) has declined with improved surgical techniques and neonatal screening; however, as these patients live longer, accurate estimates of the prevalence of adults with CHD are lacking.MethodsTo determine the prevalence and mortality trends of adults with CHD, we combined National Vital Statistics System data and National Health Interview Survey data using an integrative systems model to determine the prevalence of recalled CHD as a function of age, sex, and year (by recalled CHD, we mean positive response to the question “has a doctor told you that (name) has congenital heart disease?”, which is a conservative lower-bound estimate of CHD prevalence). We used Human Mortality Database estimates and US Census Department projections of the US population to calculate the CHD-prevalent population by age, sex, and year. The primary outcome was prevalence of recalled CHD in adults from 1970 to 2050; the secondary outcomes were birth prevalence and mortality rates by sex and women of childbearing age (15–49 years).ResultsThe birth prevalence of recalled CHD in 2010 for males was 3.29 per 1,000 (95 % uncertainty interval (UI) 2.8–3.6), and for females was 3.23 per 1,000 (95 % UI 2.3–3.6). From 1968 to 2010, mortality among zero to 51-week-olds declined from 170 to 53 per 100,000 person years. The estimated number of adults (age 20–64 years) with recalled CHD in 1968 was 118,000 (95 % UI 72,000–150,000). By 2010, there was an increase by a factor of 2.3 (95 % UI 2.2–2.6), to 273,000 (95 % UI 190,000–330,000). There will be an estimated 510,000 (95 % UI: 400,000–580,000) in 2050. The prevalence of adults with recalled CHD will begin to plateau around the year 2050. In 2010, there were 134,000 (95 % UI 69,000–160,000) reproductive-age females (age 15–49 years) with recalled CHD in the United States.ConclusionMortality rates have decreased in infants and the prevalence of adults with CHD has increased but will slow down around 2050. This population requires adult medical systems with providers experienced in the care of adult CHD patients, including those familiar with reproduction in women with CHD.

【 授权许可】

CC BY   
© Benziger et al. 2015