Ethnic-specific mortality of infants undergoing congenital heart surgery in England and Wales

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Implantation of Total Artificial Heart in Congenital Heart Disease
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Published on: July 18, 2014

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Rachel L Knowles1, Deborah Ridout2, Sonya Crowe3

  • 1Life Course Epidemiology & Biostatistics, UCL Great Ormond Street Institute of Child Health, London, UK.

Archives of Disease in Childhood
|March 3, 2019
PubMed

Insights

Infants of British Asian and other non-white ethnicities had higher mortality after heart surgery compared to white infants. These disparities persisted even after accounting for socioeconomic factors, indicating a need for further investigation.

Area of Science:

  • Paediatric Cardiology
  • Public Health
  • Health Disparities Research

Background:

  • Congenital heart defects (CHDs) are a significant cause of infant mortality.
  • Ethnic variations in healthcare outcomes are increasingly recognized.
  • Understanding these variations is crucial for equitable care in paediatric cardiac surgery.

Purpose of the Study:

  • To investigate ethnic differences in mortality rates for infants with CHDs.
  • To analyze mortality risk associated with cardiac surgery or interventional catheterisation across different ethnic groups.

Main Methods:

  • An observational study utilizing linked national paediatric cardiac surgery and intensive care audit data.
  • Survival to age 1 year was analyzed using multivariable Poisson models with multiple imputation.
  • Key predictors including ethnicity, comorbidities, and surgical factors were assessed.

Main Results:

  • Overall infant mortality was 83.9 per 1000 infants.
  • Infants of British Asian and 'all other' non-white ethnicities showed significantly higher mortality risk (RR 1.52 and 1.62, respectively) compared to white infants.
  • Higher mortality was observed during index hospital admission and elective readmission for British Asian infants.

Conclusions:

  • Non-white ethnic groups, particularly British Asian infants, face elevated postoperative mortality risk.
  • Socioeconomic deprivation and access to care partially explained these disparities but did not fully account for them.
  • Further research into case-mix and risk timing is needed to understand underlying mechanisms of ethnic disparities in paediatric cardiac care.
Abstract

Keywords:
cardiac surgerycardiologymortalityrace and health

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