Mental health diagnoses in hospitalized adults with congenital heart disease in the state of Texas: A 10-year review

Background: Adults with congenital heart disease (ACHD) face psychological challenges. Furthermore, ACHD patients experience an under-recognition of mental health disorders (MHD). Understanding the impact of MHDs on ACHD hospitalizations may better inform and help re-design the ACHD care model. Methods: A retrospective review of the Texas Inpatient Discharge Dataset (TIDD) was performed. Data was queried across a ten-year period, from the beginning of 2009 to the end of 2018. ACHD discharges as well as twelve different MHD were identified utilizing ICD-9/10 diagnostic codes. Demographic characteristics and outcomes were recorded. CHD were classified using the American College of Cardiology (ACC)/American Heart Association (AHA) lesion severity score system (LSS). Results: A total of 10,515 eligible discharges were identified, of which 1643(15.6%) had at least one MHD. Demographic differences were found for those with a mental health, anxiety, or depression diagnosis when compared to those without. ACHD patients with MHD had a longer length of stay (LOS) compared to those without (5 [3-8] vs. 4 [2-7] days, p < 0.001). LSS differences were found for patients with an anxiety or depression diagnosis when compared to those without. After adjusting for demographic variables, a LSS 3 was associated with a mental health, anxiety, or depression diagnosis. After adjusting for demographic variables and LSS, a longer LOS was also associated with a mental health, anxiety, or depression diagnosis. Conclusions: These findings highlight the need for mental health evaluation within the ACHD care model. Further research should analyze optimum care delivery for ACHD with mental health care in mind.