Racial and Ethnic Disparities in Postoperative Mortality Following Congenital Heart Surgery Open Access

Oster, Matthew Edward (2011)

Permanent URL: https://etd.library.emory.edu/concern/etds/pg15bf570?locale=en
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Abstract


An abstract of
A thesis submitted to the Faculty of the
Rollins School of Public Health of Emory University
in partial fulfillment of the requirements for the degree of
Master of Public Health
in Epidemiology
2011



Abstract
Racial and Ethnic Disparities in Postoperative Mortality Following Congenital Heart
Surgery
By Matthew E. Oster
Objectives: This study assessed racial/ethnic disparities in postoperative mortality following
surgery for congenital heart disease (CHD) and explored whether disparities persist after
adjusting for access to care.
Study Design: We used the Pediatric Health Information System database to perform a
retrospective cohort study of 44,017 patients with 49,833 CHD surgery encounters in 2004-2008
at 41 children's hospitals. We used chi-square analysis to compare unadjusted mortality rates by
race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic) and constructed Poisson
regression models to determine adjusted mortality risk ratios (RRs) and 95% confidence intervals
(CIs).
Results: In-hospital postoperative mortality rate was 3.4%; non-Hispanic whites had the lowest
mortality rate (2.8%), followed by non-Hispanic blacks (3.6%) and Hispanics (3.9%) (p<0.0001).
After adjusting for age, sex, genetic syndrome, and surgery risk category, the RR of death was
1.32 for non-Hispanic blacks (CI 1.14-1.52) and 1.21 for Hispanics (CI 1.07-1.37), both
compared with non-Hispanic whites. After adjusting for access to care (insurance type and
hospital of surgery), these estimates did not appreciably change (non-Hispanic blacks: RR=1.27,
CI 1.09-1.47; Hispanics: RR=1.22, CI 1.05-1.41).
Conclusion: There are notable racial/ethnic disparities in postoperative mortality following CHD
surgery that do not appear to be explained by differences in access to care.

Table of Contents


Table of Contents

Title, Author(s), Abstract
1


Background
3


Methods
4


Results
6


Discussion
7


References
13


Tables
17


Figures
20




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