Survival in Children With Congenital Heart Disease: Have We Reached a Peak at 97%?
Open accessAbstract
Background: Despite advances in pediatric health care over recent decades, it is not clear whether survival in children with congenital heart disease (CHD) is still increasing. Methods and Results: We identified all patients with CHD using nationwide Swedish health registries for 1980 to 2017. We examined the survival trends in children with CHD; we investigated the mortality risk in patients with CHD compared with matched controls without CHD from the general population using Cox proportional regression models and Kaplan–Meier survival analysis. Among 64 396 patients with CHD and 639 012 matched controls without CHD, 3845 (6.0%) and 2235 (0.3%) died, respectively. The mean study follow‐up (SD) was 11.4 (6.3) years in patients with CHD. The mortality risk was 17.7 (95% CI, 16.8–18.6) times higher in children with CHD compared with controls. The highest mortality risk was found during the first 4 years of life in patients with CHD (hazard ratio [HR], 19.6; 95% CI, 18.5–20.7). When stratified by lesion group, patients with non‐conotruncal defects had the highest risk (HR, 97.2; 95% CI, 80.4–117.4). Survival increased substantially according to birth decades, but with no improvement after the turn of the century where survivorship reached 97% in children with CHD born in 2010 to 2017. Conclusions: Survival in children with CHD has increased substantially since the 1980s; however, no significant improvement has been observed this century. Currently, >97% of children with CHD can be expected to reach adulthood highlighting the need of life‐time management.
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One in four children with congenital heart disease will undergo at least one surgical intervention before age 18.
“One of every 4 children with CHD will undergo at least one surgical intervention prior to the age of 18. 1,2”
From Advanced wireless monitoring for children in the cardiac perioperative setting (2023) · cites this paper as [1]
The Results report that 23.2% of children with CHD underwent a cardiac intervention between birth and age 18, approximately one in four. But the Methods define cardiac intervention as either cardiovascular surgery or interventional catheterization, so the paper does not establish that one in four underwent surgery. (LLM, conf=0.90)
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References 46 · Cited by 430
- Authors
- Mandalenakis, Z., Giang, K. W., Eriksson, P., Liden, H., Synnergren, M., Wåhlander, H., Fedchenko, M., Rosengren, A., & Dellborg, M.
- Affiliations
- University of Gothenburg (SE)
- Department of Paediatrics Institute of Clinical Sciences Sahlgrenska Academy University of Gothenburg Sweden
- Corresponding author
- Mandalenakis, Zacharias
- ORCID
- Venue
- Journal of the American Heart Association
- Published
- 2020-11-17
- Volume
- 9
- Issue
- 22
- Pages
- e017704-e017704
- ISSN
- 2047-9980 (ISSN-L)
- PMC
- PMC7763707
- OpenAlex
- W3097393781
- Cited by
- 430
- References
- 46
- Citations by year
- 2026: 79 · 2025: 111 · 2024: 103 · 2023: 63 · 2022: 48 · 2021: 23 · 2020: 3
- FWCI
- 24.55
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Journal of the American Heart Association (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiovascular Conditions and Treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Congenital heart defects research
- Keywords
- congenital heart disease, child survival, mortality risk, survival trends, early childhood mortality, birth cohort, lifetime management, pediatric cardiology
- MeSH terms
- Adolescent, Child, Child, Preschool, Female, Heart Defects, Congenital, Humans, Infant, Male, Registries, Sweden, Survival Rate, Proportional Hazards Models, Case-Control Studies, Child Mortality, Kaplan-Meier Estimate
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