The burden and outcomes of vaccine-preventable infections among adult congenital heart disease patients: a nationwide analysis

Background: Comorbidities increase the risk of adverse outcomes from infections. This study aimed to assess the prevalence and outcomes of vaccine-preventable infections (VPI) in adult congenital heart disease (ACHD) patients compared to the general population. Methods: Using the 2016–2020 National Inpatient Sample database, we identified VPI hospitalizations and compared outcomes between ACHD patients and the general population. The primary study outcome was in-hospital mortality, with secondary outcomes including respiratory failure, acute kidney injury, acute liver failure, septic shock, cardiac arrest, length of stay, and total hospital charges. Results: Of 647,440 patients hospitalized for VPI, 2610 (0.3%) had ACHD. After adjustment for baseline characteristics, ACHD patients had similar odds of in-hospital mortality (adjusted odds ratio [aOR] 1.12, 95% confidence interval [CI] 0.64–1.98), respiratory failure (aOR 1.05, 95% CI 0.84–1.32), septic shock (aOR 1.03, 95% CI 0.66–1.60), and cardiac arrest (aOR 1.01, 95% CI 0.36–2.74), but higher odds of acute kidney injury (aOR 1.34, 95% CI 1.09–1.67) and acute liver failure (aOR 1.27, CI 1.01–1.60) compared to the general population. Conclusion: ACHD patients hospitalized for VPI have similar in-hospital mortality, but higher acute kidney injury and liver failure rates compared to the general population, highlighting the importance of vaccination in this vulnerable patient group.