• Titus Chan, K Casey Lion, and Rita Mangione-Smith.
• Department of Pediatrics, University of Washington, Seattle, WA; Division of Critical Care Medicine and the Heart Center, Seattle Children's Hospital, Seattle, WA.
• J. Pediatr. 2015 Apr 1;166(4):812-8.e1-4.

ObjectiveTo determine if racial/ethnic disparities exist among children undergoing congenital heart surgery, using failure-to-rescue (FTR) as a measure of hospital-based quality.Study DesignThis is a retrospective, repeated cross-sectional analysis using admissions from the 2003, 2006, and 2009 Kids' Inpatient Database. All pediatric admissions (≤ 18 years) with a Risk Adjustment for Congenital Heart Surgery procedure were included. Logistic regression models examining complications, FTR, and overall mortality were constructed.ResultsHispanic ethnicity (OR 1.13, 95% CI 1.01-1.26) was associated with increased odds of experiencing a complication when compared with white race. However, black race (OR 1.66, 95% CI 1.33-2.07) and other race/ethnicity (OR 1.40, 95% CI 1.10-1.79) were risk factors for FTR. Although Hispanic ethnicity was associated with increased odds of experiencing a complication, it was not associated with FTR. In hospital fixed-effects models, black race and other race/ethnicity remained as "within hospital" risk factors for FTR.ConclusionsBlack children and children of other race/ethnicity had higher rates of mortality after experiencing a complication. This suggests that racial disparities may exist in hospital-based cardiac care or response to care.Copyright © 2015 Elsevier Inc. All rights reserved.

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