Racial and Ethnic Variation in ECMO Utilization and Outcomes in Pediatric Cardiac ICU Patients

Area of Science:

• Pediatric Cardiology
• Critical Care Medicine
• Health Disparities Research

Background:

• Previous research indicates racial disparities in extracorporeal membrane oxygenation (ECMO) use among pediatric cardiac patients.
• Understanding these disparities is crucial for equitable healthcare delivery.

Purpose of the Study:

• To investigate racial and ethnic variations in ECMO utilization for pediatric cardiac conditions.
• To determine if observed mortality differences are mediated by ECMO utilization rates.

Main Methods:

• A multicenter, retrospective cohort study using the Pediatric Cardiac Critical Care Consortium registry.
• Logistic regression models analyzed associations between race/ethnicity, ECMO use, and mortality, adjusted for confounders.
• Analyses were stratified by hospitalization type (medical vs. surgical).

Main Results:

• Black and other races showed higher odds of ECMO utilization in surgical hospitalizations.
• Hispanic ethnicity was associated with increased mortality odds.
• Racial/ethnic disparities in mortality persisted even after accounting for ECMO utilization.

Conclusions:

• Racial and ethnic disparities in pediatric cardiac ECMO utilization and outcomes are evident.
• Increased ECMO use in surgical cases for Black and other races was observed.
• Addressing disparities requires examining factors beyond ECMO utilization, focusing on comprehensive care.