Racial and ethnic disparities in post-operative mortality following congenital heart surgery

J Pediatr. 2011 Aug;159(2):222-6. doi: 10.1016/j.jpeds.2011.01.060. Epub 2011 Mar 17.

Abstract

Objectives: This study assessed racial/ethnic disparities in post-operative mortality after surgery for congenital heart disease (CHD) and explored whether disparities persist after adjusting for access to care.

Study design: We used the Pediatric Health Information System database to perform a retrospective cohort study of 44,017 patients with 49,833 CHD surgery encounters in 2004-2008 at 41 children's hospitals. We used χ(2) analysis to compare unadjusted mortality rates by race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic) and constructed Poisson regression models to determine adjusted mortality risk ratios (RRs) and 95% CIs.

Results: In-hospital post-operative mortality rate was 3.4%; non-Hispanic whites had the lowest mortality rate (2.8%), followed by non-Hispanic blacks (3.6%) and Hispanics (3.9%) (P < .0001). After adjusting for age, sex, genetic syndrome, and surgery risk category, the RR of death was 1.32 for non-Hispanic blacks (CI, 1.14-1.52) and 1.21 for Hispanics (CI, 1.07-1.37), both compared with non-Hispanic whites. After adjusting for access to care (insurance type and hospital of surgery), these estimates did not appreciably change (non-Hispanic blacks: RR, 1.27; CI, 1.09-1.47; Hispanics: RR, 1.22; CI, 1.05-1.41).

Conclusions: There are notable racial/ethnic disparities in post-operative mortality after CHD surgery that do not appear to be explained by differences in access to care.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Cardiac Surgical Procedures*
  • Child, Preschool
  • Continental Population Groups*
  • Ethnic Groups*
  • Female
  • Follow-Up Studies
  • Heart Defects, Congenital / ethnology*
  • Heart Defects, Congenital / surgery
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Postoperative Period
  • Retrospective Studies
  • Survival Rate / trends
  • United States / epidemiology