Insight into the Role of the Child Opportunity Index on Surgical Outcomes in Congenital Heart Disease

Mayourian, Joshua; Brown, Ella R.; Javalkar, Karina; Bucholz, Emily M.; Beroukhim, Rebecca S.; Feins, Eric N.; Kheir, John N.; Triedman, John K.; Dionne, Audrey

doi:10.1016/j.jpeds.2023.113464

Cited by 17 publications

(10 citation statements)

References 46 publications

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“…Results from Duong et al [19 ▪▪ ] suggest that those in the lowest COI quintile (i.e., highest level of social disadvantage) may be at particularly high risk of poorer outcomes. Further, results from neighborhood and patient-level analyses in the Mayourian et al [20 ▪▪ ] study revealed that neighborhood-level indices associated with longer length of stay (i.e., food and housing insecurity, lack of health insurance, lower socioeconomic status, and lower parental literacy and education) were also associated with increased risk for mortality. At the patient-level, children with public insurance and those with Spanish-speaking caregivers had higher mortality rates [20 ▪▪ ].…”

Section: Social Determinants Of Health Across the Perioperative Conti...mentioning

confidence: 95%

“…The role of SDOH on surgical and in-hospital outcomes has been explored in samples of children undergoing surgery for congenital heart disease, orthopedic surgery, or appendectomy. In children undergoing congenital heart disease surgery, higher social disadvantage, as measured by the COI, was shown to be associated with longer length of stay and likelihood of in-hospital mortality [19 ▪▪ ,20 ▪▪ ]. Myourian et al [20 ▪▪ ] conducted additional analyses to identify neighborhood and patient-level variables that accounted for the association between social disadvantage and length of stay.…”

Section: Social Determinants Of Health Across the Perioperative Conti...mentioning

confidence: 99%

“…In children undergoing congenital heart disease surgery, higher social disadvantage, as measured by the COI, was shown to be associated with longer length of stay and likelihood of in-hospital mortality [19 ▪▪ ,20 ▪▪ ]. Myourian et al [20 ▪▪ ] conducted additional analyses to identify neighborhood and patient-level variables that accounted for the association between social disadvantage and length of stay. Results indicated that neighborhood-level indices of food and housing insecurity, lack of health insurance, lower socioeconomic status, and lower parental literacy and education were associated with longer hospital length of stay.…”

Section: Social Determinants Of Health Across the Perioperative Conti...mentioning

confidence: 99%

“…Previously introduced studies assessing SDOH in pediatric patients undergoing congenital heart disease surgery [19 ▪▪ ,20 ▪▪ ] also examined effects of social disadvantage on postsurgical mortality and survival rates. Results of this work revealed a positive association between COI-measured social disadvantage and increased risk for mortality and poorer survival rates.…”

Section: Social Determinants Of Health Across the Perioperative Conti...mentioning

confidence: 99%

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The intersection of pediatric anesthesiology and social determinants of health

Martin,

Kain

2024

Current Opinion in Anaesthesiology

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Purpose of review There is increasing evidence of racial and ethnic disparities in pediatric perioperative care, which indicates a need to identify factors driving disparities. Social determinants of health (SDOH) play a fundamental role in pediatric health and are recognized as key underlying mechanisms of healthcare inequities. This article summarizes recent research exploring the influence of SDOH on pediatric perioperative outcomes. Recent findings Despite the scarcity of research exploring SDOH and pediatric perioperative outcomes, recent work demonstrates an association between SDOH and multiple outcomes across the perioperative care continuum. Measures of social disadvantage were associated with preoperative symptom severity, longer hospital stays, and higher rates of postoperative complications and mortality. In some studies, these adverse effects of social disadvantage persisted even when controlling for medical comorbidities and clinical severity. Summary The existing literature offers compelling evidence of the impact of SDOH on perioperative outcomes in children and reveals a critical area in pediatric anesthesia that necessitates further exploration and action. To improve outcomes and address care inequities, future efforts should prioritize the integration of SDOH assessment into pediatric perioperative research and practice.

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Section: Social Determinants Of Health Across the Perioperative Conti...mentioning

confidence: 95%

Section: Social Determinants Of Health Across the Perioperative Conti...mentioning

confidence: 99%

Section: Social Determinants Of Health Across the Perioperative Conti...mentioning

confidence: 99%

Section: Social Determinants Of Health Across the Perioperative Conti...mentioning

confidence: 99%

See 2 more Smart Citations

The intersection of pediatric anesthesiology and social determinants of health

Martin,

Kain

2024

Current Opinion in Anaesthesiology

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“…The impact of SDOH on surgical and other early-childhood outcomes in CHD is too broad to adequately cover in this review. It is worth noting that there is extensive research into the disparities that exist in a variety of health outcomes, including surgical mortality, medical complications, and neurodevelopmental outcomes for children living with CHD [27][28][29][30][31][32][33][34]. In a broad systematic review of the literature, SDOHs are found to be "significantly associated with adverse outcomes across the lifespan of CHD patients.…”

Section: Sdoh On Surgical and Other Early Childhood Outcomesmentioning

confidence: 99%

Untangling the Complex Associations between Socioeconomic and Demographic Characteristics and Prenatal Detection and Outcomes in Congenital Heart Disease

Klein,

Donofrio

2024

JCDD

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Recent literature has established a strong foundation examining the associations between socioeconomic/demographic characteristics and outcomes for congenital heart disease. These associations are found beginning in fetal life and influence rates of prenatal detection, access to timely and appropriate delivery room and neonatal interventions, and surgical and other early childhood outcomes. This review takes a broad look at the existing literature and identifies gaps in the current body of research, particularly as it pertains to disparities in the prenatal detection of congenital heart disease within the United States. It also proposes further research and interventions to address these health disparities.

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