Registro y análisis de la población adulta con cardiopatías congénitas en la región de murcia

Résumé

Congenital heart disease is a group of diseases characterized by the presence of structural alterations of the heart produced by defects in its formation during the embryonic period, which are therefore present from birth. These patients have some particularities in terms of management that should be better known, in order to adapt care and follow-up to national and international recommendations and guidelines, which would improve their health outcomes. Our hypothesis is that the population aged 14 years or older with congenital heart disease in the Region of Murcia constitutes a large and varied group of patients, who would not be under optimal follow-up. The main objective is to describe the prevalence of congenital heart disease in patients aged 14 years or older living in the Region of Murcia. As secondary objectives, a descriptive epidemiological study was carried out that included: distribution and characteristics of the population, type and severity of heart disease in the population, association or not with syndromes or chromosomal disorders, clinical situation, types of surgical and hemodynamic procedures performed, hospital centers of follow-up and frequency. Methodology: Observational, descriptive and retrospective study of epidemiological data obtained from the medical records of the study population, namely, subjects diagnosed with congenital heart disease with an age equal to or greater than 14 years followed in healthcare centers of the Public Health Service of the Region of Murcia. The database is developed using the Microsoft Access Database relational database management system, version 365 of the Microsoft Office suite. Qualitative variables are described using tables of absolute frequencies and percentages. Quantitative variables are described using the mean central tendency measure and the dispersion, standard deviation, and range measurements. Prevalences are considered in relation to 100,000 inhabitants. A univariate analysis is performed to study the possible relationship between qualitative variables using the Chi-square independence test. A significance level of alfa = 0.05 has been set for the analysis. The data was analyzed using IBM Corp. statistical software, IBM SPSS Statistics v28. Results: A total of 48,338 medical records were reviewed, including 1,216 patients for study. The estimated prevalence of adult congenital heart disease in the Region of Murcia is 93.54 per 100,000 inhabitants. There is no gender predominance and the median age is 24 years. 93.3% of the patients were of Spanish origin. The most common heart diseases are: atrial septal defects, ventricular septal defects, pulmonary valvular stenosis, patent ductus arteriosus, spectrum of coarctations/hypoplasias/aortic interruptions, atrioventricular septal defects, tetralogies of Fallot, and transpositions of great arteries. These 8 groups represent 85.9% of the total number of heart diseases collected. Most patients are in a good functional situation. The need for intervention through surgery and/or catheterization, although more frequent in children or young adults, persists throughout life. Follow-up has been very uneven, both in terms of the hospitals of care and the frequency of follow-up, with poorly unified criteria. Conclusions: Our results indicate the need for a Congenital Heart Disease Service that encompasses the Pediatric Cardiology and Adult Congenital Heart Disease Sections and has pediatric cardiologists, adult cardiologists, surgeons and hemodynamicists, along with professionals from other specialties, who assume this pathology throughout the patient's life. This would unify criteria for action, avoid loss of follow-up and unnecessary referrals, and provide more orderly and comprehensive care to these patients.