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Associations between Child Opportunity Index and Pediatric Cardiac Surgical Outcomes.
Kolwaite, Amy R; Edwards, Johnathan A; Higgins, Melinda; Kandaswamy, Swaminathan; Orenstein, Evan; Boughton, Dawn; Zinyandu, Tawanda; Brasher, Susan; Shashidharan, Subhadra; Thompson, Lisa M; Chanani, Nikhil K.
Afiliación
  • Kolwaite AR; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA. Electronic address: akolwaite@cdc.gov.
  • Edwards JA; Rollins School of Public Health, Emory University, Atlanta, GA; University of Lincoln, School of Health and Social Care, Lincolnshire, UK.
  • Higgins M; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA.
  • Kandaswamy S; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
  • Orenstein E; Rollins School of Public Health, Emory University, Atlanta, GA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Division of Hospital Medicine, Children's Healthcare of Atlanta, Atlanta, GA; Information Services and Technology, Children's Healthcare of Atlanta, Atlanta, GA
  • Boughton D; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
  • Zinyandu T; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
  • Brasher S; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA.
  • Shashidharan S; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
  • Thompson LM; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA; Rollins School of Public Health, Emory University, Atlanta, GA.
  • Chanani NK; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.
J Pediatr ; 270: 114000, 2024 Jul.
Article en En | MEDLINE | ID: mdl-38432295
ABSTRACT

OBJECTIVE:

To assess the relationship between the Child Opportunity Index (COI), a comprehensive measurement of social determinants of health, and specific COI domains on patient-specific outcomes following congenital cardiac surgery in the metropolitan region of Atlanta, Georgia. STUDY

DESIGN:

In this retrospective chart review, we included patients who underwent an index operation for congenital heart disease between 2010 and 2020 in a single pediatric health care system. Patients' addresses were geocoded and mapped to census tracts. Descriptive statistics, univariable analysis, and multivariable regression models were employed to assess associations between variables and outcomes.

RESULTS:

Of the 7460 index surgeries, 3798 (51%) met eligibility criteria. Presence of an adverse outcome, defined as either mortality or 1 of several other major postoperative morbidities, was significantly associated with COI in the univariable model (P = .008), but not the multivariable regression model (P = .39). Postoperative hospital length of stay was significantly associated with COI (P < .001) in univariable and multivariable regression models. There was no significant association between COI and readmission within 30 days of hospital discharge in univariable (P < .094) and multivariable (P = .49) models.

CONCLUSION:

COI is associated with postoperative hospital length of stay but not all outcomes in patients after congenital heart surgery. By understanding the role of COI in outcomes related to cardiac surgery, targeted interventions can be developed to improve health equity.
Asunto(s)

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Cardiopatías Congénitas / Procedimientos Quirúrgicos Cardíacos Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Año: 2024 Tipo del documento: Article

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Cardiopatías Congénitas / Procedimientos Quirúrgicos Cardíacos Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn País/Región como asunto: America do norte Idioma: En Revista: J Pediatr Año: 2024 Tipo del documento: Article