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Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
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Racial Health Disparity Associated With Poor Pediatric Cardiac Surgery Outcomes: A Multicentered, Cross-Sectional

Shaun P Setty1,2, Lauren C Reynolds3, Vanessa C Chou3

  • 1Division of Pediatric Cardiac Surgery, MemorialCare Heart and Vascular Institute, Long Beach, California, USA.

JACC. Advances
|August 12, 2024
PubMed
Summary

Racial disparities impact pediatric cardiac surgery outcomes, with non-White children experiencing higher mortality and longer hospital stays. Further research is needed to address these health disparities in pediatric cardiac surgery.

Keywords:
RACHS-2extracorporeal membrane oxygenationheart surgerymorbiditymortalityneonates

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Area of Science:

  • Pediatric Cardiac Surgery
  • Health Disparities Research
  • Congenital Heart Disease Outcomes

Background:

  • Health disparities are recognized as a significant factor influencing outcomes in pediatric cardiac surgery.
  • Existing research indicates a link between socioeconomic and racial factors and patient prognosis.

Purpose of the Study:

  • To assess risk factors associated with adverse clinical outcomes in pediatric cardiac surgery.
  • To investigate the impact of race on mortality and length of stay after pediatric cardiac surgery.

Main Methods:

  • Utilized the Pediatric Health Information System Database (October 2015-December 2020).
  • Categorized 59,856 pediatric patients by cardiac surgery complexity using Risk Adjustment for Congenital Heart Surgery-2 (RACHS-2).
  • Performed multivariable regression analyses to identify significant risk factors for mortality and postoperative length of stay.

Main Results:

  • Non-White race was independently associated with a 1.2-fold increased mortality risk (P=0.008) and longer postoperative length of stay by 1.04 days (P<0.001).
  • These disparities were more pronounced in non-White neonates, showing a 1.3-fold increased mortality risk (P=0.003) and a 2.05-week longer postoperative length of stay (P<0.001).
  • Factors like mechanical ventilation, ECMO, infection, and surgical complications significantly increased mortality.

Conclusions:

  • Racial differences significantly affect outcomes in pediatric cardiac surgery, particularly in neonates.
  • Findings highlight the need for further evaluation and mitigation strategies to address racial disparities in pediatric cardiac surgery care.