Associations between social determinants of health (SDOH) and adverse outcomes for children with congenital heart disease (CHD) are starting to be recognized; however, such links remain understudied. We examined the relationship between community-level material deprivation on mortality, readmission, and length of stay (LOS) for children undergoing surgery for CHD. We performed a retrospective cohort study of patients who underwent cardiac surgery at our institution from 2015 to 2018. A community-level deprivation index (DI), a marker of community material deprivation, was generated to contextualize the lived experience of children with CHD. Generalized mixed-effects models were used to assess links between the DI and outcomes of mortality, readmission, and LOS following cardiac surgery. The DI and components were scaled to provide mean differences for a one standard deviation (SD) increase in deprivation. We identified 1,187 unique patients with surgical admissions. The median LOS was 11 days, with an overall mortality rate of 4.6% and readmission rate of 7.6%. The DI ranged from 0.08 to 0.85 with a mean of 0.37 (SD 0.12). The DI was associated with increased LOS for patients with more complex heart disease (STAT 3, 4, and 5), which persisted after adjusting for factors that could prolong LOS (all p < 0.05). The DI approached but did not meet a significant association with mortality (p = 0.0528); it was not associated with readmission (p = 0.36). Community-level deprivation is associated with increased LOS for patients undergoing cardiac surgery. Future work to identify the specific health-related social needs contributing to LOS and identify targets for intervention is needed.

人们开始认识到健康社会决定因素 (SDOH) 与先天性心脏病 (CHD) 儿童不良后果之间的关联；然而，这种联系仍未得到充分研究。我们研究了社区层面的物质匮乏与接受先心病手术的儿童的死亡率、再入院和住院时间 (LOS) 之间的关系。我们对 2015 年至 2018 年在我们机构接受心脏手术的患者进行了一项回顾性队列研究。社区层面的剥夺指数（DI）是社区物质剥夺的标志，旨在将先天性心脏病儿童的生活经历置于背景中。广义混合效应模型用于评估 DI 与心脏手术后死亡率、再入院和 LOS 结局之间的联系。对 DI 和组件进行缩放，以提供剥夺增加一个标准差 (SD) 的平均差异。我们确定了 1,187 名接受手术入院的独特患者。中位住院时间为 11 天，总死亡率为 4.6%，再入院率为 7.6%。DI 范围为 0.08 至 0.85，平均值为 0.37 (SD 0.12)。对于患有更复杂的心脏病的患者（STAT 3、4 和 5），DI 与 LOS 增加相关，在调整可能延长 LOS 的因素后，这种情况持续存在（所有p  < 0.05）。DI 接近但未达到与死亡率的显着相关性 ( p  = 0.0528)；它与再入院无关（p  = 0.36）。社区层面的剥夺与接受心脏手术的患者的 LOS 增加有关。未来需要开展工作来确定导致 LOS 的特定健康相关社会需求并确定干预目标。