Poorer Kids May Fare Worse After Heart Surgery

Children who’ve had surgery to repair a defective heart are more likely to die or require longer hospitalizations if they live in poorer neighborhoods, a new study suggests.

The disparities between affluent and poor children persisted even though all were treated at the same major hospitals, the researchers said. And those disparities were only partially explained by differences in race or insurance coverage.

“The fact that there are disparities in health care is nothing new, but it was particularly shocking to see this big an effect in this population,” said study author Dr. Brett Anderson. She’s an assistant professor of pediatrics at Columbia University Medical Center in New York City.

“All of the children included in this study [were] being treated at highly specialized centers,” Anderson added. “Our study really said the neighborhood was a significant predictor over and above the effects of income. This tells us we really have a long way to go.”

Developing in early pregnancy, congenital heart defects are present in babies at birth. They involve abnormalities of the chambers, valves or blood vessels of the heart and affect at least 8 in every 1,000 babies, according to the American Heart Association.

Ranging from mild to severe, congenital heart defects can disrupt the ability of the heart to pump properly and also raise the risk of developing various conditions. They are the most common birth defects in the United States and are associated with both the highest death and highest hospitalization rates in children, according to the study.

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SOURCES: Brett Anderson, M.D., M.B.A., assistant professor, pediatrics, division of pediatric cardiology, Columbia University Medical Center, and attending pediatric cardiologist, Morgan Stanley Children's Hospital of New York-Presbyterian, New York City; Shaine Morris, M.D., pediatric cardiologist, Texas Children's Hospital, Houston; Feb. 23, 2018, Pediatrics, online

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