The Critical Transfer From Paediatrics to Adult Care in Patients With Congenital Heart Disease: Predictors of Transfer and Retention of Care

• Published in: CJC pediatric and congenital heart disease 2022-06, Vol.1 (3), p.129-135
• Main Authors: Suliman, Asem, Mao, Ruochen, Hiebert, Brett, Tam, James W., Shah, Ashish H., Soni, Reeni, Ducas, Robin A.
• Format: Article
• Language: English
• ISSN: 2772-8129; 2772-8129
• DOI: 10.1016/j.cjcpc.2022.04.003

Congenital heart disease is the most common congenital birth defect and presents with differing degrees of complexity. Patients require lifelong specialized care. The transfer from paediatric to adult care is a time of risk that may result in lapses or loss of care. A successful transfer from paediatric to adult care is integral for improved patient outcomes. In this retrospective study, we used the paediatric cardiology database and the electronic records at the adult congenital heart disease (ACHD) clinic to identify referrals and successful transfer between 2008 and 2017. Successful transfer was defined as a patient referred to the ACHD clinic who was seen in the clinic and has ongoing follow-up. We also sought to identify predictors of a successful transfer. A total of 555 patients were referred to the ACHD clinic (2008-2017). Of all patients referred, 62% had a successful transfer and an ongoing specialist care. The remaining 38% either did not show for first appointments or missed 3 consecutive visits. Independent predictors of a successful transfer were the presence of moderate or complex ACHD, residing within the city limits, older age at the time of referral, and a more recent year of referral. Over one-third of patients did not achieve successful transfer, namely attendance at first clinic visit plus early retention in care. We were able to identify several variables that predict successful transfer. Further research is required to identify interventions that can be implemented to reduce lapses in patient care. La cardiopathie congénitale, qui est la malformation congénitale la plus courante, présente divers degrés de complexité. Les patients qui en sont atteints nécessitent des soins spécialisés tout au long de leur vie. La transition entre les soins pédiatriques et les soins pour adultes est un moment risqué qui peut occasionner un relâchement ou une interruption des soins. Le succès de ce transfert des soins pédiatriques aux soins pour adultes est essentiel à l’amélioration des résultats pour les patients. Pour cette étude rétrospective, nous avons utilisé la base de données de cardiologie pédiatrique et les dossiers électroniques de la clinique de cardiopathie congénitale de l’adulte (CCA) pour relever les cas de réorientation et de transfert réussi survenus entre 2008 et 2017. On entendait par « transfert réussi » le fait qu’un patient orienté vers la clinique de CCA ait été vu en consultation à la clinique et qu’il fasse l’objet d’un suivi.