Racial variations in extracorporeal membrane oxygenation use following congenital heart surgery

Abstract

Black children and children of other race are at increased odds of mortality after congenital heart surgery. These disparities can be traced to variations in ECMO utilization across racial/ethnic groups.

Socio‐economic inequalities in mortality in children with congenital heart disease: A systematic review and meta‐analysis

“…The following types of mortality were analysed: in‐hospital (n = 10), infant (<1 year, n = 6), neonatal (<28 days, n = 2), postoperative (n = 2), post‐discharge (n = 3), intra‐stage (n = 2), and long‐term (>1 year, n = 6) (see Table for study‐specific definitions). Four measures of SES were reported in the included studies: area‐based poverty (n = 13), parental (maternal or paternal) or area‐based education (n = 9), individual health insurance status (n = 8), and area‐based income (n = 8) . The definitions for SES measures used in individual studies are given in Table .…”

“…The definitions for SES measures used in individual studies are given in Table . The included articles were based on US (n = 22), UK (n = 5), and Panama (n = 1) populations. Most articles included all CHD subtypes combined (n = 21), with the rest including cases of HLH or single ventricle (SV) defects (n = 5), atrioventricular septal defect (AVSD, n = 1), and a composite group of “critical” subtypes (n = 1) .…”

“…The included articles were based on US (n = 22), UK (n = 5), and Panama (n = 1) populations. Most articles included all CHD subtypes combined (n = 21), with the rest including cases of HLH or single ventricle (SV) defects (n = 5), atrioventricular septal defect (AVSD, n = 1), and a composite group of “critical” subtypes (n = 1) . Cases were ascertained from congenital anomaly registers (n = 11), the Kids Inpatient Database (KIDS, n = 4), the SV reconstruction (SVR) trial (n = 2), clinical databases (n = 2), the Paediatric Health Information system (n = 2), medical records, or hospital discharges (n = 7) .…”

“…Cases were ascertained from congenital anomaly registers (n = 11), the Kids Inpatient Database (KIDS, n = 4), the SV reconstruction (SVR) trial (n = 2), clinical databases (n = 2), the Paediatric Health Information system (n = 2), medical records, or hospital discharges (n = 7) . Many articles ascertained cases postoperatively (n = 17), with these tending to ascertain cases from medical records. All but one article ascertained cases in childhood .…”

“… The following definitions of health insurance categories were provided: Chan et al:“Public” insurance was defined as government insurance. DeMone et al: “Private” insurance (referred to in the article as commercial insurance) included Blue Cross/Blue Shield, non‐Blue Cross/Blue Shield commercial carriers, and self‐insurance.…”