Congenital heart diseaseCohort study
Impact of Social Determinants of Health on Predictive Models for Outcomes After Congenital Heart Surgery
- Retrospective cohort study
- multicentre
Authors' conclusion
Although indiscriminate inclusion of social determinants in clinical risk modeling can conceal inequities, thoughtful consideration can help centers understand their performance across populations and guide efforts to improve health equity.
Study context
- Population
- Congenital heart surgeries across New York State, 2006–202112,321 cases at 8 centers
- Participants
- 10,271 surgeries
- Exposure
- Risk models with vs without social determinants of health
- Outcome
- Operative and longitudinal mortality; risk model performance
Main finding
As reported in the abstract
Operative model performance, before to after inclusion
0.834-0.844
Longitudinal model performance, before to after inclusion
0.808-0.811
More survivors appropriately risk classified with inclusion
10.0%
More mortalities appropriately risk classified with inclusion
4.8%
Observational data: associations, not effects.
Further findings
Mortality (single cohort)
- Died in hospital or before 30 days
- 327 (2.7%)
- Died by December 31, 2021
- 314
- Total deaths
- 641; 6.2%
Center performance classification
- Centers changing performance classification category (wide site variation in reclassification)
- 2 of 8
Original publication
Summarised from the published abstract; every number is checked against it