Congenital heart disease (CHD) is the most common form of congenital defect among newborns, with a global birth prevalence of 9.4 per 1000.  As the life expectancy of patients with CHD is increasing, the population is substantially growing and ageing, especially in higher-income countries. Because patients with CHD remain at increased risk for comorbidities, they require lifelong follow-up to optimize outcomes. The epidemiological characteristics and healthcare needs of the ‘emerging’ group of older adults with CHD should be identified for optimal care planning. In addition, the focus has expanded from improving longevity to also enhancing patient-reported outcomes. However, gaps in our knowledge base remain.  Although a broad list of PROs and explanatory factors were included in the original APPROACH-IS study, only part of the variation in PROs could be explained, indicating a need to investigate the association between PROs and additional explanatory factors.  Moreover, a particular type of PRO, experiences with health care, remain largely uninvestigated in adults with CHD, leaving questions unanswered about the quality of care, the geographical variation and predictors of patient-reported experiences with care. Furthermore, the initial APPROACH-IS study included patients from 13 high-income and two middle-income countries. 

An understanding of PROs in patients living in low- and middle-income countries, in comparison to high-income countries, is still lacking. Furthermore, as adults with CHD are ageing, many will encounter disability, morbidity and a state of frailty, thereby increasing susceptibility for adverse outcomes and premature mortality. To maintain longevity and quality of life, an understanding of variables associated with prognosis, comorbidity and mortality will enable us to map specific healthcare needs.  Frailty phenotype refers to a distinct clinical syndrome that classifies patients as non-frail, pre-frail, or frail based upon the assessment of five criteria: weakness, slow walking speed, unintentional weight loss, exhaustion, and low physical activity.  Growing evidence suggests that independent of age and comorbidity, frailty phenotyping can guide risk prediction in chronically ill patients.  Unfortunately, our current knowledge about epidemiological characteristics, frailty phenotype and healthcare needs of ageing adults with CHD is very limited. 

visit for more articles at Journal of Heart and Cardiovascular Research

Kindly submit your article at  https://www.imedpub.com/submissions/heart-cardiovascular-research.html

Regards
Mishita
Jornal co-ordinator
Journal of Heart and Cardiovascular Research