Cardiology in the young · 2026
Ethnicity and survival after paediatric cardiac surgery in the UK.
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Cave Daniel G W, Mustafa Khurram, Cromie Kirsten, Feltbower Richard G, Glaser Adam W, Bentham James R
Аннотация
OBJECTIVES: To assess the impact of ethnicity on survival following paediatric cardiac surgery.
METHODS: Observational study of a regional tertiary paediatric cardiac surgical centre in Yorkshire, UK. All children (age 0-15 years) undergoing their first cardiac surgical procedure from January 2005 to December 2021 inclusive. The primary outcome was 5-year survival. Secondary outcomes included 30-day, 1-year, and pre-discharge survival.
RESULTS: 3,508 children (46% female) underwent their first cardiac surgical procedure during the study period. Within the study cohort 2,578 (73%) children were White, 634 (18%) were South Asian, 95 (3%) were Black and 201 (6%) were from other ethnic groups. South Asian children were more likely to have a functionally single-ventricle (10% vs. 7% White; relative risk 1.41, 95% confidence interval 1.15-1.69).Mortality after surgery, adjusted for deprivation, was higher for South Asian (hazard ratio 1.50, 1.12-2.01) and Black children (hazard ratio 1.69, 0.93-3.06), compared to White children. Survival differences were not present at discharge or 30 days post-procedure, but widened progressively at 90 days, 1 year and 5 years. This was not influenced by diagnosis or pre-operative risk factors. One-year survival improved for South Asian children across the study period and was similar to that of White children from 2017-2021 (94.7% (89.8-97.3%) vs. 96.8% (94.9-97.9%) White).
CONCLUSIONS: Black and South Asian children have a greater risk of death following cardiac surgery compared to White children, independent of pre-operative risk. The majority of excess deaths occurred after hospital discharge. Although inequities have steadily reduced over the past two decades, the explanation for this effect remains unclear.
METHODS: Observational study of a regional tertiary paediatric cardiac surgical centre in Yorkshire, UK. All children (age 0-15 years) undergoing their first cardiac surgical procedure from January 2005 to December 2021 inclusive. The primary outcome was 5-year survival. Secondary outcomes included 30-day, 1-year, and pre-discharge survival.
RESULTS: 3,508 children (46% female) underwent their first cardiac surgical procedure during the study period. Within the study cohort 2,578 (73%) children were White, 634 (18%) were South Asian, 95 (3%) were Black and 201 (6%) were from other ethnic groups. South Asian children were more likely to have a functionally single-ventricle (10% vs. 7% White; relative risk 1.41, 95% confidence interval 1.15-1.69).Mortality after surgery, adjusted for deprivation, was higher for South Asian (hazard ratio 1.50, 1.12-2.01) and Black children (hazard ratio 1.69, 0.93-3.06), compared to White children. Survival differences were not present at discharge or 30 days post-procedure, but widened progressively at 90 days, 1 year and 5 years. This was not influenced by diagnosis or pre-operative risk factors. One-year survival improved for South Asian children across the study period and was similar to that of White children from 2017-2021 (94.7% (89.8-97.3%) vs. 96.8% (94.9-97.9%) White).
CONCLUSIONS: Black and South Asian children have a greater risk of death following cardiac surgery compared to White children, independent of pre-operative risk. The majority of excess deaths occurred after hospital discharge. Although inequities have steadily reduced over the past two decades, the explanation for this effect remains unclear.