Trends and predictors of mortality among children and adolescents with congenital heart disease in Ethiopia: A retrospective follow-up study.
Congenital heart disease mortality in Ethiopian children declined significantly from 2015 to 2024.
Trends and predictors of mortality among children and adolescents with congenital heart disease in Ethiopia: A retrospective follow-up study.
Congenital heart disease (congenital heart disease) is a leading noninfectious cause of mortality during childhood and adolescence, particularly in developing countries where timely diagnosis and treatment are limited.
This study aimed to assess mortality trends and identify predictors among children with congenital heart disease in a resource-limited setting.
We conducted a retrospective follow-up study on 6228 children and adolescents with congenital heart disease who received care at the Cardiac Center of Ethiopia, either as outpatients or inpatients, with follow-up between 2015 and 2024.
annual congenital heart disease mortality fell steadily over the decade
The median age of patients was 0.7 years (interquartile range, 0.3-3.8 years), with a female-to-male ratio of 1.42:1.
During follow-up, 827 patients (13.3%) died.
Malnutrition increased mortality risk by 2.9-fold (adjusted hazard ratio [AHR]: 2.9; 95% CI: 1.9-3.9; P < 0.001), pulmonary hypertension (pulmonary hypertension) by 3.5-fold (AHR: 3.5; 95% CI: 2.2-6.6; P < 0.001), and the presence of syndromic associations (with or without extracardiac anomalies) by 30% (AHR: 1.3; 95% CI: 1.1-2.2; P = 0.04).
Mortality among children and adolescents with congenital heart disease in Ethiopia has shown a significant decline in recent years.
However, malnutrition, pulmonary hypertension, syndromic associations, and lack of surgical or interventional care remain key predictors of poor outcomes.
Strengthening timely access to interventions, enhancing nutritional and multidisciplinary support, and prioritizing early identification of high-risk patients are essential to further reduce congenital heart disease-related mortality in resource-limited settings.