Epidemiology of paediatric chronic heart failure in Germany-A population-based analysis.

Epidemiology Germany Heart failure Incidence Paediatric Prevalence

Journal

ESC heart failure
ISSN: 2055-5822
Titre abrégé: ESC Heart Fail
Pays: England
ID NLM: 101669191

Informations de publication

Date de publication:
03 Sep 2024
Historique:
revised: 21 07 2024
received: 19 06 2024
accepted: 19 08 2024
medline: 3 9 2024
pubmed: 3 9 2024
entrez: 3 9 2024
Statut: aheadofprint

Résumé

Paediatric chronic heart failure (CHF) is associated with significant morbidity. The aim of this study was to describe paediatric CHF epidemiology in Germany. This is a retrospective cross-sectional analysis of anonymized healthcare claims data in the InGef database. This database includes longitudinal data from a representative sample of the German population of approximately 4.8 million insured members. We included individuals <18 years from 2016 to 2021. CHF was defined by ≥2 diagnoses in different quarters of the year as inpatient or outpatient, using ICD-10-GM codes I50.- or P29.0. The number of eligible children in the database was 674 462 in 2016 and 660 692 in 2021. Prevalence of CHF per 100 000 children was 20.6 [95% confidence interval (CI), 17.3-24.3] in 2016 and 19.4 (95% CI, 16.2 to 23.0) in 2021. Incidence per 100 000 children was 9.6 (95% CI, 7.4 to 12.3) in 2016 and 7.6 (95% CI, 5.6 to 10.0) in 2021 for newly diagnosed CHF. All-cause hospitalizations occurred in 47.3% to 57.7% of children with CHF per year. Up to 6.3% of children with CHF were hospitalized, coded primarily for heart failure. Mortality of children with CHF was <5 death per year in the studied population. In 128 children with CHF in 2021, the most common ICD-coded comorbidities were congenital malformations of cardiac septa (57.8%), atrial septal defect (44.5%), congenital malformations of the great arteries (43.0%) and ventricular septal defect (32.0%). Coded treatment modalities for paediatric CHF in 2021 included angiotensin-converting enzyme inhibitors or angiotensin II type 1 receptor blockers (18.8%), beta-blockers (17.2%), mineralocorticoid receptor antagonists (14.8%) and surgical procedures (13.3%). This representative cohort study reveals a relatively high incidence proportion. Approximately half of the children with CHF are hospitalized annually while mortality is low.

Identifiants

pubmed: 39225059
doi: 10.1002/ehf2.15043
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Subventions

Organisme : Novartis Pharma GmbH

Informations de copyright

© 2024 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

Références

Watanabe K, Shih R. Update of pediatric heart failure. Pediatr Clin North Am 2020;67:889‐901. doi:10.1016/j.pcl.2020.06.004
Masarone D, Valente F, Rubino M, Vastarella R, Gravino R, Rea A, et al. Pediatric heart failure: a practical guide to diagnosis and management. Pediatr Neonatol 2017;58:303‐312. doi:10.1016/j.pedneo.2017.01.001
Rickers C, Läer S, Diller G‐P, Janousek J, Hoppe UC, Mir TS, Weil J. Leitlinie Pädiatrische Kardiologie: Chronische Herzinsuffizienz. Beschlossen vom Vorstand der Deutschen Gesellschaft für Pädiatrische Kardiologie am 28.10.2015. 2015. https://www.dgpk.org/wp‐content/uploads/LL_Chronische_Herzinsuffizienz_Nov_2015_Rickers.pdf. [Accessed 2 March 2024].
Adebiyi EO, Edigin E, Shaka H, Hunter J, Swaminathan S. Pediatric heart failure inpatient mortality: a cross‐sectional analysis. Cureus 2022;14:e26721. doi:10.7759/cureus.26721
Amdani S, Marino BS, Rossano J, Lopez R, Schold JD, Tang WHW. Burden of pediatric heart failure in the United States. J Am Coll Cardiol 2022;79:1917‐1928. doi:10.1016/j.jacc.2022.03.336
Shaddy RE, George AT, Jaecklin T, Lochlainn EN, Thakur L, Agrawal R, et al. Systematic literature review on the incidence and prevalence of heart failure in children and adolescents. Pediatr Cardiol 2018;39:415‐436. doi:10.1007/s00246‐017‐1787‐2
Das BB. Current state of pediatric heart failure. Children (Basel) 2018;5:5. doi:10.3390/children5070088
Ahmed H, VanderPluym C. Medical management of pediatric heart failure. Cardiovasc Diagn Ther 2021;11:323‐335. doi:10.21037/cdt‐20‐358
McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Böhm M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J 2021;42:3599‐3726. doi:10.1093/eurheartj/ehab368
Ludwig M, Enders D, Basedow F, Walker J, Jacob J. Sampling strategy, characteristics and representativeness of the InGef research database. Public Health 2022;206:57‐62. doi:10.1016/j.puhe.2022.02.013
Statistisches Bundesamt. Bevölkerung: Deutschland, Stichtag, Altersjahre. 2021. Code: 12411‐0005. https://www‐genesis.destatis.de/genesis/online?sequenz=tabellen&selectionname=12411*#abreadcrumb. [Accessed 19 November 2023].
Sommers C, Nagel BHP, Neudorf U, Schmaltz AA. Herzinsuffizienz im Kindesalter. Eine epidemiologische Studie. [Congestive heart failure in childhood. An epidemiologic study]. Herz 2005;30:652‐662. doi:10.1007/s00059‐005‐2596‐6
Masutani S, Saiki H, Kurishima C, Ishido H, Tamura M, Senzaki H. Heart failure with preserved ejection fraction in children: hormonal imbalance between aldosterone and brain natriuretic peptide. Circ J 2013;77:2375‐2382. doi:10.1253/circj.cj‐12‐1271
Rossano JW, Kim JJ, Decker JA, Price JF, Zafar F, Graves DE, et al. Prevalence, morbidity, and mortality of heart failure‐related hospitalizations in children in the United States: a population‐based study. J Card Fail 2012;18:459‐470. doi:10.1016/j.cardfail.2012.03.001
Störk S, Handrock R, Jacob J, Walker J, Calado F, Lahoz R, et al. Epidemiology of heart failure in Germany: a retrospective database study. Clin Res Cardiol 2017;106:913‐922. doi:10.1007/s00392‐017‐1137‐7
Jiménez‐García R, Esteban‐Vasallo MD, Rodríguez‐Rieiro C, Hernandez‐Barrera V, Domínguez‐Berjón MAF, Carrasco Garrido P, et al. Coverage and predictors of vaccination against 2012/13 seasonal influenza in Madrid, Spain: analysis of population‐based computerized immunization registries and clinical records. Hum Vaccin Immunother 2014;10:449‐455. doi:10.4161/hv.27152
Adekanmbi AF, Ogunlesi TA, Olowu AO, Fetuga MB. Current trends in the prevalence and aetiology of childhood congestive cardiac failure in Sagamu. J Trop Pediatr 2007;53:103‐106. doi:10.1093/tropej/fml064
Abdulkadir MB, Ibraheem RM, Issa A, Suberu HD, Owolabi BI, Alabi K. Prevalence, etiology, and fatality rates of childhood heart failure in Nigeria: a systematic review and meta‐analysis. Int J Health Sci (Qassim) 2023;17:53‐60.
Andrews RE, Fenton MJ, Ridout DA, Burch M. New‐onset heart failure due to heart muscle disease in childhood: a prospective study in the United Kingdom and Ireland. Circulation 2008;117:79‐84. doi:10.1161/CIRCULATIONAHA.106.671735
Tseng C‐H. The age‐ and sex‐specific incidence and medical expenses of heart failure hospitalization in 2005 in Taiwan: a study using data from the National Health Insurance. J Am Geriatr Soc 2010;58:611‐613. doi:10.1111/j.1532‐5415.2010.02755.x
Webster G, Zhang J, Rosenthal D. Comparison of the epidemiology and co‐morbidities of heart failure in the pediatric and adult populations: a retrospective, cross‐sectional study. BMC Cardiovasc Disord 2006;6:23. doi:10.1186/1471‐2261‐6‐23
Damman K, Valente MAE, Voors AA, O'Connor CM, van Veldhuisen DJ, Hillege HL. Renal impairment, worsening renal function, and outcome in patients with heart failure: an updated meta‐analysis. Eur Heart J 2014;35:455‐469. doi:10.1093/eurheartj/eht386
Moffett BS, Humlicek TJ, Rossano JW, Price JF, Cabrera AG. Readmissions for heart failure in children. J Pediatr 2016;177:153‐158.e3. doi:10.1016/j.jpeds.2016.06.003
Hussey AD, Weintraub RG. Drug treatment of heart failure in children: focus on recent recommendations from the ISHLT guidelines for the management of pediatric heart failure. Paediatr Drugs 2016;18:89‐99. doi:10.1007/s40272‐016‐0166‐4
Weisert M, Su JA, Menteer J, Shaddy RE, Kantor PF. Drug treatment of heart failure in children: gaps and opportunities. Paediatr Drugs 2022;24:121‐136. doi:10.1007/s40272‐021‐00485‐9
Deutsche Stiftung Organtransplantation. Herztransplantation 2021: Herztransplantation: Grafiken zum Tätigkeitsbericht 2021 nach § 11 Abs. 5 TPG. 2022. https://dso.de/BerichteTransplantationszentren/Grafiken%20D%202021%20Herz.pdf. [Accessed 16 July 2023].

Auteurs

Alexej Bobrowski (A)

Department of Congenital Heart Defects and Pediatric Cardiology, University Heart Center Freiburg - Bad Krozingen, Medical Center - University of Freiburg, Freiburg, Germany.

Sven Klebs (S)

Novartis Pharma GmbH, Nuremberg, Germany.

Marco Alibone (M)

InGef - Institute for Applied Health Research Berlin GmbH, Berlin, Germany.

Leonore Bovy (L)

InGef - Institute for Applied Health Research Berlin GmbH, Berlin, Germany.

Dennis Häckl (D)

WIG2 GmbH, Leipzig, Germany.
Chair of Health Economics and Management, Faculty of Economics and Management Science, Leipzig University, Leipzig, Germany.

Thilo Fleck (T)

Department of Congenital Heart Defects and Pediatric Cardiology, University Heart Center Freiburg - Bad Krozingen, Medical Center - University of Freiburg, Freiburg, Germany.

Brigitte Stiller (B)

Department of Congenital Heart Defects and Pediatric Cardiology, University Heart Center Freiburg - Bad Krozingen, Medical Center - University of Freiburg, Freiburg, Germany.

Classifications MeSH