Pulmonary vascular disease & thromboembolismCohort study
Child Opportunity Index Influences Pediatric Pulmonary Hypertension Outcomes
- retrospective cohort study
Authors' conclusion
In this study of pediatric PH outcomes by SDoH at U.S. children's hospitals, lower COI, Black/African American race, public insurance, and greater home-to-hospital distance were associated with higher mortality.
Study context
- Population
- Pediatric pulmonary hypertension patients with encounters from January 1, 2016, to December 31, 2022, at children's hospitals in the Pediatric Health Information Systempediatric pulmonary hypertension (PH) patients, 47 children's hospitals · pulmonary arterial hypertension 11,296 · left heart disease 2,332 · lung disease 9,165 · thromboembolic 180 · other 1,348
- Participants
- 24,321 patients
- Exposure
- Demographics, therapeutics, and outcomes were compared according to social determinants of health (SDoH) including Child Opportunity Index (COI 3.0), race/ethnicity, insurance status, urbanicity, and home-to-hospital distance
Main finding
As reported in the abstract
Deaths
died
1,702 (7.0%)
Observational data: associations, not effects.
Further findings
| Outcome | adjusted OR (95% CI) | P value | |
|---|---|---|---|
| Mortality (multivariable) · lower odds of mortality with very high COI quintile | 0.78 (0.67–0.90) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
| Outcome | very high COI quintile | very low quintile | Estimate | P value |
|---|---|---|---|---|
| Unadjusted mortality by COI quintile | Not reported in the abstract | 8.5% |
- Unadjusted mortality by COI quintile: very high 6.1%
- Unadjusted mortality by COI quintile: P < 0.001
- Mortality (multivariable): adjusting for baseline unmodifiable factors and condition severity/therapy use
Therapy use by COI
- No difference in the therapy use was observed by COI
Mortality by insurance, race and distance
- Mortality was higher for patients with public insurance, Black/African American race and those living further from hospital
Median age at first admission
- median age at first admission
- 1 year (IQR: 0, 5)
Original publication
Child Opportunity Index Influences Pediatric Pulmonary Hypertension Outcomes. JACC Adv. doi:10.1016/j.jacadv.2026.102773
Summarised from the published abstract; every number is checked against it