Congenital heart diseaseCohort study
Neighborhood Childhood Opportunity, Race/Ethnicity, and Surgical Outcomes in Children With Congenital Heart Disease
- Retrospective cohort study
- multicentre
- mediation analysis
Authors' conclusion
Children in the lowest COI quintile are at risk for poor outcomes after CHD surgery. Disproportionally increased mortality in Black, Asian, and Other populations may be partially mediated by COI.
Study context
- Population
- Children aged <18 years undergoing cardiac surgery for CHD, Pediatric Health Information System, 2016–2022encounters at 47 centers
- Participants
- 54,666 children
- Exposure
- Race/ethnicity and Childhood Opportunity Index quintiles
- Outcome
- In-hospital surgical death
Main finding
As reported in the abstract
In-hospital mortality
- Black (Black) · adjusted
- OR 1.20; P = 0.01
- Asian · adjusted
- OR 1.75; P < 0.001
- Other · adjusted
- OR 1.50; P < 0.001
- Lowest Childhood Opportunity Index (COI) quintile · partially adjusted
- OR 1.29; P = 0.004
- Lowest COI quintile · fully adjusted
- OR 1.14; P = 0.13
Observational data: associations, not effects.
Further findings
| Outcome | HR | P value |
|---|---|---|
| Neonatal survival after discharge (multivariable) · median follow-up 0.70 years · poorer survival | 1.21 | P = 0.04 |
- Neonatal survival after discharge (multivariable): n = 13,987
Mediation by COI of race/ethnicity effect on in-hospital mortality
- Proportion mediated, lowest
- 2.6% (P = 0.64)
- Proportion mediated, highest
- 16.8% (P = 0.029)
- depending on model specification
Original publication
Neighborhood Childhood Opportunity, Race/Ethnicity, and Surgical Outcomes in Children With Congenital Heart Disease. J Am Coll Cardiol. Published 29 August 2023. doi:10.1016/j.jacc.2023.05.069
Summarised from the published abstract; every number is checked against it