Sex Differences in Mortality in Children Undergoing Congenital Heart Disease Surgery: A United States Population–Based Study

  title={Sex Differences in Mortality in Children Undergoing Congenital Heart Disease Surgery: A United States Population–Based Study},
  author={Ariane Marelli and Kimberlee Gauvreau and Michael Landzberg and Kathy J Jenkins},
Background— The changing demographics of the adult congenital heart disease (CHD) population requires an understanding of the factors that impact patient survival to adulthood. We sought to investigate sex differences in CHD surgical mortality in children. Methods and Results— Children <18 years old hospitalized for CHD surgery were identified using the Kids' Inpatient Database in 2000, 2003, and 2006. Demographic, diagnostic, and procedural variables were grouped according to RACHS-1 (Risk… 

Figures from this paper

Sex differences in hospital mortality in adults with congenital heart disease: the impact of reproductive health.
Association Between Down Syndrome and In-Hospital Death Among Children Undergoing Surgery for Congenital Heart Disease: A US Population-Based Study
In this large national study, children with DS who underwent repair of congenital heart disease were more likely to survive to discharge than children without DS and future work is needed to understand the factors underlying these differences.
Age‐Dependent Sex Effects on Outcomes After Pediatric Cardiac Surgery
Patient sex has a significant effect on mortality after pediatric cardiac operations, with an increased risk of death in early infancy for girls after high‐risk cardiac operations.
Congenital Heart Disease Hospitalizations in Canada: A 10-Year Experience.
Current trends in racial, ethnic, and healthcare disparities associated with pediatric cardiac surgery outcomes
Racial/ethnic disparities in congenital heart surgical outcomes may be changing compared with previous studies using the KID database, and increased length of stay in children with government- sponsored insurance may reflect expansion of individual states government-sponsored insurance eligibility criteria for children with complex chronic medical conditions.
Contemporary survival of adults with congenital heart disease
Insight is given in the contemporary survival of adults with CHD that may aid patient counselling, timing of interventions and future research.
Changing Epidemiology of Congenital Heart Disease
It has now been shown that specialized adults with congenital heart disease (ACHD) care improves mortality, yet the majority of patients are not being followed in specialized centers, and age-specific processes of care referral need to be elaborated to improve follow-up and minimize lapses in care.
Characteristics of in-hospital mortality of congenital heart disease (CHD) after surgical treatment in children from 2005 to 2017: a single-center experience
The mortality rate of CHD surgery in children decreased year by year, and the younger the age and the more complicated the cyanotic heart disease, the higher the mortality rate may be.
US Mortality Due To Congenital Heart Disease Across the Lifespan from 1999-2017 Exposes Persistent Racial/Ethnic Disparities
While overall US mortality due to CHD has decreased over the last 19 years, disparities in mortality persist for males compared to females and for non-Hispanic Blacks compared tonon-Hispanic Whites, which will be important moving into the next decade.


Sex-related disparity in surgical mortality among pediatric patients.
Female gender is associated with an 18% higher in-hospital and 30-day postdischarge mortality as compared with male gender and the mechanism by which female gender acts as a risk factor requires further investigation.
Female Sex as a Risk Factor for In-Hospital Mortality Among Children Undergoing Cardiac Surgery
For children undergoing cardiac surgery, female sex was associated with 51% higher odds of death than male sex, and the mechanism by which female sex acts as a risk factor requires further investigation.
Gender and Outcome in Adult Congenital Heart Disease
The risk of several major cardiac outcomes in adult patients with congenital heart disease appears to vary by gender, and the risk of arrhythmias appeared to be lower in women than in men.
Congenital Heart Disease in the General Population: Changing Prevalence and Age Distribution
The prevalence of severe CHD increased from 1985 to 2000, but the increase in adults was significantly higher than that observed in children, and in 2000, there were nearly equal numbers of adults and children with severeCHD.
Center-specific differences in mortality: preliminary analyses using the Risk Adjustment in Congenital Heart Surgery (RACHS-1) method.
The RACHS-1 method can be used to judge relative institutional performance, either by evaluating within-risk-category differences or by comparisons of observed and expected mortality rates.
Consensus-based method for risk adjustment for surgery for congenital heart disease.
The RACHS-1 method should adjust for baseline risk differences and allow meaningful comparisons of in-hospital mortality for groups of children undergoing surgery for congenital heart disease.
Differences in the use of procedures between women and men hospitalized for coronary heart disease.
It is demonstrated that women who are hospitalized for coronary heart disease undergo fewer major diagnostic and therapeutic procedures than men.
Mortality Associated With Congenital Heart Defects in the United States: Trends and Racial Disparities, 1979–1997
Mortality from heart defects is declining in the United States, although it remains a major cause of death in infancy and childhood, and age at death is increasing, suggesting that more affected persons are living to adolescence and adulthood.
The spectrum of adult congenital heart disease in Europe: morbidity and mortality in a 5 year follow-up period. The Euro Heart Survey on adult congenital heart disease.
The spectrum of adult CHD in Europe emerging from this survey is one of a predominantly young population with substantial morbidity but relatively low mortality in a 5 year period.