日本小児循環器学会雑誌 Pediatric Cardiology and Cardiac Surgery

Background: Infants with congenital heart disease living at home may have unscheduled hospitalizations. Efforts to moderate unplanned hospitalizations require clarifying the causation of such incidents; therefore, we conducted a study to identify the related etiological factors along with the total number of children affected.

Methods: The medical records of children with congenital heart disease in infancy who had been hospitalized at hospital A during a period of 5 years were collected and analyzed.

Results: Unplanned hospitalization was required for 35.4％ of children with congenital heart disease in infancy. Most of these hospitalized patients were aged ＜1 year (31.7％), and many of them had chromosomal abnormalities. The main causes were respiratory complications such as pneumonia and bronchitis as well as worsening cardiorespiratory status, including heart failure, low SpO₂, cyanosis, and hypoxemia. Home oxygen therapy was used in 50.3％, home ventilatory therapy in 7.9％, and home tube-feeding therapy in 26.0％.

Conclusions: Unplanned hospitalization of children with congenital heart disease was most common in children less than 1 year of age. It was affected by the underdevelopment and vulnerability of respiratory and circulatory functions. Minimizing unplanned hospitalizations will require seamless support from both medical professionals in the institution and nursing staff in the home.