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

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

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Medicine and Surgery Health Sciences, Epidemiology
Keyword	pediatric congenital heart disease ethnicity cardiology children mortality race
Committee Chair / Thesis Advisor	Strickland, Matthew J, Emory University
Partnering Agencies	Emory University schools, faculty or affiliated programs

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