Presence of and hospital resource utilization for comorbid ventricular septal defects in pediatric patients: A cross-sectional study in Shanghai, China

Abstract

Abstract Objectives To describe the characteristics of high-incidence comorbidity combinations of pediatric ventricular septal defect (VSD) among inpatients in Shanghai, China. Methods In total, 5,994 inpatient pediatric VSD cases with ICD-10-based diagnoses were retrospectively studied. The top combinations and influencing factors associated with comorbidities were analyzed by the chi-squared test. Results Patients were predominantly aged 0–1 year (50.47%), had one admission (90.89%), and had surgery once (37.14%) or twice (38.71%). Major comorbidities were cardiovascular and respiratory. VSD + atrial septal defect (ASD) (14.58%), VSD + ASD + secondary pulmonary hypertension (PH) (4.75%) and VSD + ASD + patent ductus arteriosus (PDA) + secondary PH (0.67%) affected the most patients in each comorbidity group. Other top comorbidity groups included VSD + patent foramen ovale (PFO) (4.05%), VSD + ASD + primary PH (2.92%) and VSD + ASD + secondary PH + pneumonia (0.53%). Characteristics of the combinations were examined, and age, with the highest prevalence seen in those aged between 0 and 1 year, number of operations (p < 0.001 in each comorbidity group), length of stay (LOS) (p = 0.001 in the 2 comorbidities group; p = 0.002 in the 4 comorbidities group) and hospitalization cost (p < 0.001 in the 2 comorbidities group; p = 0.011 in the 3 comorbidities group) differed significantly. Conclusions VSD + ASD, VSD + ASD + PH, and VSD + ASD + PDA + secondary PH occurred most frequently in each comorbidity group. Age, number of operations, LOS and hospitalization cost were significant among these combinations, which emphasizes the importance of a better understanding, diagnosis and treatment for complex comorbidities of VSD in young populations to improve clinical outcomes and provide guidance for relevant policies on resource utilization.