A study published this week in Pediatrics revealed racial disparities in postsurgical mortality and complications in children. According to the study, differences in health outcomes for African American versus white patients "is not novel." The study states that race is a "key determinant of postoperative outcomes" and that in general, African American patients have higher rates of postoperative morbidity and mortality when compared to their white peers. This new study's objective was to understand the racial disparities in postoperative outcomes among apparently healthy children.
Using information from the National Surgical Quality Improvement Program (Pediatric), the research team analyzed the outcomes of 172,529 children who had inpatient operations from 2012 to 2017. According to Scientific American, to ensure that the children were generally healthy, the researchers only used patients who had an American Society of Anesthesiologists physical status of 1 or 2.
In an article from Scientific American regarding the study, Olubukola Nafiu, co-author and pediatric anesthesiologist at Nationwide Children's Hospital (Columbus, Ohio), explained, "We talk about economic factors, the nonavailability of hospitals in African American communities, or how sick a patient is when they present. We decided to ask, 'What if we're dealing with relatively healthy patients?'"
Overall, the analysis found a 0.02% risk of 30-day mortality with a 13.9% chance of postoperative complications and a 5.7% chance of other serious adverse events. The study revealed that compared to their white peers, African American children had 3.43 times the odds of dying within 30 days of surgery. They also had an 18% greater chance of developing postoperative complications and a 7% chance of developing other serious adverse events.
The study concludes that although these rates are low, there is still a significant association between being African American and experiencing postoperative complications or deaths. Additionally, the study conveys hope that this information will be used to assess risk and guide preoperative discussions and decisions. The authors clarify that this study does not "establish causality between race and postsurgical complications or mortality." Instead, it highlights the strong association between the two as well as the disparity with white peers.