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J Pediatr. 2015 Apr;166(4):812-8.e1-4. doi: 10.1016/j.jpeds.2014.11.020. Epub 2014 Dec 30.

Racial disparities in failure-to-rescue among children undergoing congenital heart surgery.

Author information

1
Department of Pediatrics, University of Washington, Seattle, WA; Division of Critical Care Medicine and the Heart Center, Seattle Children's Hospital, Seattle, WA.
2
Department of Pediatrics, University of Washington, Seattle, WA; Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA.

Abstract

OBJECTIVE:

To determine if racial/ethnic disparities exist among children undergoing congenital heart surgery, using failure-to-rescue (FTR) as a measure of hospital-based quality.

STUDY DESIGN:

This is a retrospective, repeated cross-sectional analysis using admissions from the 2003, 2006, and 2009 Kids' Inpatient Database. All pediatric admissions (≤ 18 years) with a Risk Adjustment for Congenital Heart Surgery procedure were included. Logistic regression models examining complications, FTR, and overall mortality were constructed.

RESULTS:

Hispanic ethnicity (OR 1.13, 95% CI 1.01-1.26) was associated with increased odds of experiencing a complication when compared with white race. However, black race (OR 1.66, 95% CI 1.33-2.07) and other race/ethnicity (OR 1.40, 95% CI 1.10-1.79) were risk factors for FTR. Although Hispanic ethnicity was associated with increased odds of experiencing a complication, it was not associated with FTR. In hospital fixed-effects models, black race and other race/ethnicity remained as "within hospital" risk factors for FTR.

CONCLUSIONS:

Black children and children of other race/ethnicity had higher rates of mortality after experiencing a complication. This suggests that racial disparities may exist in hospital-based cardiac care or response to care.

PMID:
25556012
DOI:
10.1016/j.jpeds.2014.11.020
[Indexed for MEDLINE]

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