Racial and geographic disparities in timing of bidirectional Glenn and Fontan stages of single-ventricle palliation.

OBJECTIVE: In adults, race-based disparity in access to cardiovascular care has been documented. Racial differences in cardiac care for children have not been evaluated previously. METHODOLOGY: We analyzed timing of single-ventricle palliation as a function of race and geography at Duke University Medical Center (DUMC) from 1997-2000. RESULTS: African American children underwent bidirectional Glenn (BDG) at a median age of 11 months (13.8 +/- 10.8, n = 11); white children at five months (5.6 +/- 2.3, n = 29), p = 0.01. African American children underwent Fontan at 60 months (106.8 +/- 84.0, n = 9); white children at 36 months (45.6 +/- 36.0, n = 18), p = 0.005. CONCLUSIONS: African American children at DUMC underwent palliation at a later age and with more variability in age than did white children. Further investigation is needed to determine possible causes of these race-associated differences in health care delivery.