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.


METHODS
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.
Milazzo
Angelo S
AS
Pediatric Cardiovascular Program, Duke University Medical Center, Durham, North Carolina 27710, USA. milaz001@mc.duke.edu
Sanders
Stephen P
SP
Armstrong
Brenda E
BE
Li
Jennifer S
JS
D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D018729:Fontan Procedure / Q000706:statistics & numerical data*; D006297:Health Services Accessibility; D006330:Heart Defects, Congenital / Q000208:ethnology / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007223:Infant; D010166:Palliative Care; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*