Trisomy 18: disparities of care and outcomes in the State of Texas between 2009 and 2019

• Published in: Cardiology in the young Vol. 33; no. 11; pp. 1 - 2333
• Main Authors: Mizrahi, Michelle, Well, Andrew, Gottlieb, Erin A, Stewart, Eileen, Lucke, Ashley, Fraser, Charles D, Mery, Carlos M, Beckerman, Ziv
• Format: Journal Article
• Language: English
• Published: England 01.11.2023
• Subjects: Health equity; congenital heart surgery; CHD; Edwards syndrome
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S1047951123000215

To perform a statewide characteristics and outcomes analysis of the Trisomy 18 (T18) population and explore the potential impact of associated congenital heart disease (CHD) and congenital heart surgery. Retrospective review of the Texas Hospital Inpatient Discharge Public Use Data File between 2009 and 2019, analysing discharges of patients with T18 identified using ICD-9/10 codes. Discharges were linked to analyse patients. Demographic characteristics and available outcomes were evaluated. The population was divided into groups for comparison: patients with no documentation of CHD ( ), patients with CHD without congenital heart surgery ( ), and patients who underwent congenital heart surgery ( ). One thousand one hundred fifty-six eligible patients were identified: 443 (38%) , 669 (58%) , and 44 (4%) . had a lower proportion of Hispanic patients (n = 9 (20.45%)) compared to (n = 315 (47.09%)), and (n = 219 (49.44%)) (p < 0.001 for both). Patients with Medicare/Medicaid insurance had a 0.42 odds ratio (95%CI: 0.20-0.86, p = 0.020) of undergoing congenital heart surgery compared to private insurance. had a higher median total days in-hospital (47.5 [IQR: 12.25-113.25] vs. 9 [IQR: 3-24] and 2 [IQR: 1-5], p < 0.001); and a higher median number of admissions (n = 2 [IQR: 1-4]) vs. 1 [IQR: 1-2] and 1 [IQR: 1-1], (p < 0.001 for both). However, the post-operative median number of admissions for was 0 [IQR: 0-2]. After the first month of life, had freedom from in-hospital mortality similar to and superior to . Short-term outcomes for patients are encouraging, suggesting a freedom from in-hospital mortality that resembles the . The highlighted socio-economic differences between the groups warrant further investigation. Development of a prospective registry for T18 patients should be a priority for better understanding of longer-term outcomes.