Abstract：
Congenital Heart Disease (CHD) is a significant source of pediatric morbidity and mortality. As in other fields of medicine, studies have demonstrated racial and ethnic disparities in congenital heart disease outcomes. The cause of these outcome disparities is multifactorial, involving biological, behavioral, environmental, sociocultural, and systemic medical factors. Potential contributors include differences in preoperative illness severity secondary to coexisting medical conditions, differences in the rate of prenatal and early postnatal detection of CHD, and delayed access to care, as well as discrepancies in socioeconomic and insurance status, and systemic disparities in hospital care. Understanding the factors that contribute to these disparities is an essential step towards developing strategies to address them. As stewards of the perioperative surgical home, anesthesiologists have an important role in developing institutional policies that mitigate racial disparities. Here, we provide a thorough narrative review of recent research concerning perioperative factors contributing to surgical outcomes disparities for children of all ages with CHD, examine potentially modifiable contributing factors, discuss avenues for future research, and suggest strategies to address disparities both locally and nationally.
摘要：
先天性心脏病（CHD）是儿科发病率和死亡率的重要来源。和其他医学领域一样，研究表明先天性心脏病结局存在种族和民族差异.这些结果差异的原因是多方面的，涉及生物，行为，环境,社会文化,和系统的医疗因素。潜在的因素包括并存的医疗条件继发的术前疾病严重程度的差异，产前和产后早期冠心病检出率的差异，延迟获得护理，以及社会经济和保险地位的差异，以及医院护理中的系统性差异。了解造成这些差异的因素是制定解决这些差异的战略的重要一步。作为围手术期手术室的管家，麻醉师在制定减轻种族差异的制度政策方面发挥着重要作用。这里,我们对最近的研究进行了全面的叙述性综述，这些研究涉及导致所有年龄段冠心病儿童手术结局差异的围手术期因素。检查潜在的可改变的影响因素，讨论未来研究的途径，并提出解决地方和国家差异的策略。
