Children with heart failure face higher mortality rates in emergency situations compared to adults

May 9, 2022, Cleveland: Findings from a new Cleveland Clinic Children’s study found a rise in pediatric heart failure related emergency department visits and primary heart failure hospitalizations between 2012 and 2016. Congenital heart disease, cardiomyopathy and arrhythmias were responsible for the majority.

While there have been numerous adult studies highlighting the incidence of heart failure, this study, which was published today in the Journal of the American College of Cardiology, is the first to look into the national burden of pediatric heart failure across all pediatric age groups in the U.S. healthcare system regardless of insurance status.

The study analyzed data from national inpatient and emergency department databases along with mortality data from the 2012 and 2016 national vital statistics system, which reports information on all deaths occurring in the United States. Researchers found that compared to 2012, in 2016, pediatric heart failure emergency department visits rose by 82% and primary heart failure hospitalizations increased by 14%.

“We know that approximately 6.2 million adults have heart failure in the U.S., but in that population there is a better understanding of the overall burden of the disease, it’s risk factors and associated mortality, which has helped create strategies to reduce hospitalizations, re-hospitalizations and ultimately decrease mortality,” said Shahnawaz Amdani M.D., pediatric cardiologist at Cleveland Clinic Children’s and the study’s lead author. “Such national efforts have yet to be taken in the pediatric population and it’s our hope this data will encourage steps in that direction.”

While there are multiple FDA-approved medications to treat heart failure in adults, there is only one such medication for children. This study showed that while the pediatric heart failure burden was overall lower compared to adult heart failure across the healthcare system, deaths in emergency departments and in-hospital were significantly higher in children compared to adults.

“With the rise of surgically corrected congenital heart disease and improving medical care, a continued rise in the burden of pediatric heart failure is likely, so continued surveillance and reductions of preventable risk factors are necessary,” said W. H. Wilson Tang, MD, research director, and cardiologist in the Section of Heart Failure and Cardiac Transplantation Medicine in the Heart, Vascular & Thoracic Institute at Cleveland Clinic.