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Racial and Ethnic Disparities in Mortality Following Congenital Heart Surgery

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Abstract

Our objective was to assess risk-adjusted racial and ethnic disparities in mortality following congenital heart surgery. We studied 8483 congenital heart surgical cases from the Kids’ Inpatient Database 2000. Black sub-analysis was performed using predetermined regional categories. For our Hispanic sub-analyses, we categorized Hispanics into state groups according to a state’s predominant Hispanic group: West (Mexican-American), Southeast (Cuban-American), Northeast (Puerto Rican), and Mixed/Heterogeneous. Risk adjustment was performed using the Risk Adjustment for Congenital Heart Surgery method. Multivariate analyses assessed the effect of race/ethnicity and Hispanic state group on mortality and explored the effects of gender, income, insurance type, and region. Black children had a higher risk for death than Whites odds ratio (OR), [1.65; p = 0.003]. Hispanics and the Cuban-American state group showed a trend toward a higher death risk (Hispanic: OR, 1.24; p = 0.16; Southeast Cuban-American: OR 1.55; p = 0.08). Disparities were not influenced by insurance. Among Blacks, disparities were greatest in the Northeast region (OR, 2.25; p = 0.007). After adjusting for gender, income, and region, Blacks (OR, 1.76; p = 0.002) and Hispanics (OR, 1.34; p = 0.05) had a higher death risk. Racial and ethnic disparities in risk-adjusted mortality following congenital heart disease exist for Blacks and Hispanics. These disparities are not due to insurance but are partially explained by gender and region.

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Notes

  1. Arizona (AZ), California (CA), Colorado (CO), Connecticut (CT), Florida (FL), Georgia (GA), Hawaii (HI), Iowa (IA), Kansas (KS), Kentucky (KY), Maine (ME), Maryland (MD), Massachusetts (MA), Missouri (MI), North Carolina (NC), New Jersey (NJ), New York (NY), Oregon (OR), Pennsylvania (PA), South Carolina (SC), Tennessee (TN), Texas (TX), Utah (UT), Virginia (VA), Washington (WA), Wisconsin (WI), and West Virginia (WV)

  2. Percent Mexican-American: AZ, 82%; CA, 77%; CO, 62%; and TX, 76%

  3. Percent Puerto Rican: CT, 61%, MA, 47%, NJ, 32%; and NY, 36%;

  4. Percent Cuban-American: FL, 32%.

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Acknowledgement

Dr. Benavidez is supported by a NIH grant NRSA T32.

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Authors and Affiliations

  1. Department of Cardiology, Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA, 02115, USA

    O.J. Benavidez, K. Gauvreau & K.J. Jenkins

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  1. O.J. Benavidez
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  2. K. Gauvreau
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  3. K.J. Jenkins
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Correspondence to O.J. Benavidez.

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Benavidez, O., Gauvreau, K. & Jenkins, K. Racial and Ethnic Disparities in Mortality Following Congenital Heart Surgery. Pediatr Cardiol 27, 321–328 (2006). https://doi.org/10.1007/s00246-005-7121-4

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