title: Effect of race on the timing of the Glenn and Fontan procedures for single-ventricle congenital heart disease.
abstract: OBJECTIVE
  Disparities in health care have been documented between different racial groups in the United States. We hypothesize that there will be racial variance in the timing of the Glenn and Fontan procedures for children with single-ventricle physiology.
  
  
  METHODS
  We performed a retrospective review of a national pediatric intensive care unit database (Virtual PICU Performance System, LLC).
  
  
  METHODS
  Children with hypoplastic left heart syndrome, tricuspid atresia, and common ventricle, admitted from January 2006 to July 2008, were included. Data included race, weight, age, medical length of stay, Paediatric Index of Mortality 2 score, and survival.
  
  
  METHODS
  None.
  
  
  RESULTS
  There were 423 patients from 29 hospitals. The study population was 7.6% black, 13.0% Hispanic, 59.8% white, 9.2% "other," and 11.6% had missing racial/ethnic information. Diagnoses included 255 patients with hypoplastic left heart syndrome, 91 with tricuspid atresia, and 77 with common ventricle. The median age for the Glenn procedure (n = 205) was 5.5 months (interquartile range, 4.6-7.0 months) and 39.7 months (interquartile range, 32.4-50.6 months) for the Fontan procedure (n = 218). There was no difference between the median age at the time of the Glenn or Fontan procedures between the different racial/ethnic groups (p = .65 and p = .16, respectively). The medical length of intensive care unit stay for patients receiving the Glenn and Fontan procedures was 3.7 days (interquartile range, 1.9-6.1 days) and 3.7 days (interquartile range, 1.9-6.8 days), respectively. There were no differences in medical length of intensive care unit stay for the Glenn procedure between the different racial/ethnic groups (p = .21). Hispanic patients had a longer medical length of intensive care unit stay (6.3 days; interquartile range, 3.1-9.9 days) than white patients (2.9 days; interquartile range, 1.8-5.3 days) for the Fontan procedure (p = .008).
  
  
  CONCLUSIONS
  The timing of single-ventricle palliative procedures was not affected by race/ethnicity.
authors.affiliation: Department of Pediatric Critical Care, Children's Hospital of Nevada, Las Vegas, NV, USA. oscar.ingaramo@umcsn.com
authors.forename: Oscar A
authors.initials: OA
authors.lastname: Ingaramo
authors.forename: Robinder G
authors.initials: RG
authors.lastname: Khemani
authors.forename: Barry P
authors.initials: BP
authors.lastname: Markovitz
authors.forename: David
authors.initials: D
authors.lastname: Epstein
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D002675:Child, Preschool; D016208:Databases, Factual; D018729:Fontan Procedure / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006330:Heart Defects, Congenital / Q000208:ethnology* / Q000601:surgery; D006352:Heart Ventricles / Q000601:surgery*; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States; D044465:White People / Q000706:statistics & numerical data*