Related Experiment Video
Updated: Feb 11, 2026
Implantation of Total Artificial Heart in Congenital Heart Disease
Published on: July 18, 2014
Racial variations in extracorporeal membrane oxygenation use following congenital heart surgery
Titus Chan1, Cindy S Barrett2, Yuen Lie Tjoeng1
1Division of Pediatric Critical Care Medicine and The Heart Center, Seattle Children's Hospital, University of Washington, Seattle, Wash.
Insights
Black and other race children face higher mortality after congenital heart surgery. Disparities in Extracorporeal Membrane Oxygenation (ECMO) use contribute to these increased risks and impact survival rates.
Area of Science:
- Pediatric Cardiology
- Health Disparities Research
- Critical Care Medicine
Background:
- Racial and ethnic disparities are documented in pediatric congenital heart surgery outcomes.
- Extracorporeal membrane oxygenation (ECMO) is a critical support system for critically ill children post-congenital heart surgery, influencing survival.
- Variations in ECMO utilization across racial/ethnic groups may underlie survival disparities.
Purpose of the Study:
- To investigate racial and ethnic variations in postoperative Extracorporeal Membrane Oxygenation (ECMO) use following congenital heart surgery.
- To determine the association between race/ethnicity, ECMO utilization, and hospital survival rates in pediatric congenital heart surgery patients.
Main Methods:
- Analysis of the Pediatric Health Information Systems dataset from 2004-2015, including all children undergoing congenital heart surgery.
- Utilized multivariable, multinomial regression models to assess outcomes: survival without ECMO, survival with ECMO, death with ECMO, and death without ECMO.
- Adjusted for covariates to identify independent associations between race/ethnicity and mortality risk.
Main Results:
- Out of 130,860 patients, 95.4% survived without ECMO, while 1.3% survived with ECMO, 1.3% died with ECMO, and 1.9% died without ECMO.
- Black patients (OR 1.22) and patients of other races (OR 1.36) had significantly increased odds of mortality compared to white patients.
- Black patients (RR 1.31) and patients of other races (RR 1.37) showed increased risk of death without ECMO support, as did those with governmental insurance (RR 1.24).
Conclusions:
- Black children and children of other races experience higher mortality rates following congenital heart surgery.
- Disparities in survival are linked to differential utilization of Extracorporeal Membrane Oxygenation (ECMO) across racial and ethnic groups.
- Addressing ECMO utilization variations is crucial for mitigating racial/ethnic disparities in congenital heart surgery outcomes.
Objectives:
Previous studies demonstrate racial and ethnic disparities among children undergoing congenital heart surgery. Extracorporeal membrane oxygenation (ECMO) is used to support critically ill children after congenital heart surgery and improve survival. Thus, racial or ethnic variations in postoperative ECMO use following congenital heart surgery may be associated with racial/ethnic disparities in hospital survival.
Methods:
All children in the Pediatric Health Information Systems dataset undergoing congenital heart surgery from 2004 to 2015 were examined. Multivariable, multinomial regression models examining hospital survival without ECMO use, survival after ECMO, death after ECMO, and death without ECMO support were constructed.
Results:
Of 130,860 congenital cardiac surgery patients, 95.4% survived to hospital discharge without requiring ECMO support, whereas 1.3% survived after ECMO support, 1.3% died after ECMO support, and 1.9% died without receiving ECMO support. After adjustment for other covariates, black patients (odds ratio, 1.22; 95% confidence interval [CI], 1.05-1.42) and patients of other race (odds ratio, 1.36; 95% CI, 1.17-1.58) were at increased odds of mortality compared with white patients. In multivariable multinomial models, black patients had increased risk of death without ECMO support (relative risk, 1.31; 95% CI, 1.11-1.56). Patients of other race (relative risk, 1.37; 95% CI, 1.10-1.69) and governmental insurance (relative risk, 1.24; 95% CI, 1.12-1.37) were also at increased risk of death without ECMO.
Conclusions:
Black children and children of other race are at increased odds of mortality after congenital heart surgery. These disparities can be traced to variations in ECMO utilization across racial/ethnic groups.
Related Concept Videos
01:14What is Variation?
The range, standard deviation, standard error, and variance are the different measures of variation.
Range: The range is the difference between its maximum and...
01:19Variation
When independent and dependent variables are plotted on a scatter plot, the slope of a line is a value that describes the rate of change between the two...
02:53Conservative Site-specific Recombination and Phase Variation
The recognition sites for Cre recombinase called LoxP...
01:18Variation of Atmospheric Pressure
Assuming the air temperature is constant at a given altitude and that the ideal gas law of thermodynamics describes the atmosphere to a good approximation, one can find the variation of atmospheric pressure with height.
Let p(y) be the atmospheric pressure at...
02:26Comparing Copy Number Variations and SNPs
Copy number variations or CNVs are the structural variations that cover more than 1kb of DNA sequence. The single nucleotide polymorphism (SNP), on the other hand, is a single nucleotide change or a point mutation that is found in more than 1%...
01:27Anatomy of the Heart