Association of Child Opportunity Index with Outcomes in Pediatric Supraventricular Tachycardia.

Abstract

To assess the relationship between the Child Opportunity Index (COI), a validated measure that uses 29 indicators of social determinants of health linked to the US Census, and pediatric supraventricular tachycardia (SVT) management and outcomes, specifically looking at utilization of ablation. A retrospective, single-center study was performed evaluating pediatric SVT patients from January 2018 to July 2023. Patients diagnosed at < 5 years old, with pre-excitation, and with hemodynamically significant congenital heart disease were excluded. Characteristics were compared among low, moderate, and high COI categories using Kruskal-Wallis tests for continuous variables, and chi-square or Fisher's exact tests for categorical variables. Logistic regression and log-normal regression models were used to assess the relationship between COI category and primary outcomes of interest among SVT patients. A cohort of 306 patients met inclusion criteria. 45% had a high COI, 29% a moderate COI, and 26% a low COI. The odds of having one or more SVT-related hospital admissions were 3.88 times greater for the low COI patients compared to high COI patients (95% CI 1.39-10.8, p = 0.010). COI was not found to be associated with any other primary outcomes of interest, including utilization of ablation. Lower COI was associated with greater odds of admission in SVT patients but did not differ in rates of ablation or outcomes. This suggests social factors may affect resource utilization while having limited impact on treatments like ablations.