Congenital Heart Disease: A Population Study in Friuli Venezia Giulia, Italy

Background: Congenital heart disease (CHD) is the most common and severe class of major congenital malformations. Despite great interest in pathogenesis and surgical outcome of individual CHD, data from population studies on CHDs as a whole, especially in our region, are missing.

Objective: to assess epidemiology and population characteristics of children with CHD in Friuli Venezia Giulia (FVG), Italy

Methods: Children born in FVG between May 7, 2003 and December 1, 2015 with at least one ICD-9 diagnosis of CHD, and one or more admission to the University Hospital of Udine were enrolled. Hospital discharge data were retrospectively reviewed and the collected data were combined in a database including demographic data, cause of admission, eventual surgery and outcomes.

Results: 594 children, of which 48.8% male and 46.5% preterm, were included: median age was 69 months; mortality was 8.4%. CHD diagnosis and relative frequency are listed in figure 1. 15.3% of patients had surgery, the majority of which underwent multiple procedures. Comorbidities were diagnosed in 29.8% of patients, with surgical patient being more affected (50.5% vs 26%; p=0.02). Primary cause of hospitalization were congenital malformations in surgical patients (47.8% vs 22%; p=0.03), and perinatal problems in non surgical ones (32.9% vs 6.5% respectively; p=0.01). Cardiac disease was cause of hospitalization in 7.4% of surgical patient and 1.5% in non surgical ones. Number of admission and length of hospitalization appeared to be grater in surgical patients, although the difference was not statistically significant.

Conclusions: Our database describes a considerable pathological heterogeneity. Comorbidities seem to play an important role in children with CHD. Cardiac disease is cause of hospital admission less often than expected: this findings stress the necessity to assist the patient with CHD through a multidisciplinary and inclusive approach.