Impact of Adult Congenital Heart Disease Specialist Visits on Emergent Admissions: Evidence for Guidelines
Authors' conclusion
Having routine outpatient ACHD specialist visits over a 6-month period reduces the likelihood of an emergent admission in the subsequent period, findings driven by presence of medical conditions and not anatomic severity. These findings provide supporting evidence for the ACHD guidelines and implementation science research.
Study context
- Population
- Patients with adult congenital heart disease, 13 health centers, January 1, 2015 through December 31, 2019patients contributing 118,079 person-periods, an average of 7.3 periods per person
- Participants
- 16,142 patients
- Exposure
- Number of outpatient adult congenital heart defect (ACHD) specialist visits (1-2 considered routine) during a 6-month period on an emergent admission in the subsequent 6-month period
- Outcome
- Emergent admission per 6-month period
Methodological detailsstandardized electronic health record data from 13 health centers, mixed logistic regression, adjusted for cohort characteristics, CHD severity, and center
- Standardized electronic health record data from 13 health centers
- Mixed logistic regression
- Adjusted for cohort characteristics, CHD severity, and center
Main finding
As reported in the abstract
Patients with one emergent admission per 6-month period
Between 1.3% and 2.7%
Observational data: associations, not effects.
Further findings
| Outcome | Odds (times higher) | P value |
|---|---|---|
| Emergent admission in the subsequent 6-month periodZero vs routine visit | 1.34 | P < 0.05 using the Wald test |
| Emergent admission in the subsequent 6-month period3 vs routine visit | 1.67 | P < 0.05 using the Wald test |
| Emergent admission in the subsequent 6-month period4 vs routine visit | 2.08 | P < 0.05 using the Wald test |
| Emergent admission in the subsequent 6-month periodMore than 4 vs routine visit | 2.48 | P < 0.05 using the Wald test |
- Emergent admission in the subsequent 6-month period: adjusted for cohort characteristics, CHD severity, and center
Stratified adjusted analysis
- Similar J-shaped (nonlinear) relationships by presence of medical conditions but not by anatomic type
Original publication
Impact of Adult Congenital Heart Disease Specialist Visits on Emergent Admissions: Evidence for Guidelines. JACC Adv. Published 28 July 2025. doi:10.
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