Impact of race on postsurgery outcomes

July 22, 2020

Racial disparities persist in health care. A report examines the impact of these disparities on postsurgery outcomes.

Multiple past studies have illustrated the disparities in health care outcomes due to race. A report on Pediatrics looks at whether black children are likely to have more complications and greater mortality following surgery than their white peers.1

Researchers used data from the National Surgical Quality Improvement Program’s pediatric database from 2012 to 2017. The database collects information from 186 medical centers in the United States. They identified children who had inpatient surgery and were assigned an American Society of Anesthesiologists physical status 1 or 2. Outpatient procedures were not included because of the low level of mortality seen in them.

There were 172,549 healthy children included in the data. In this group, the incidence of 30-day mortality was 0.02%; postoperative complications was 13.9%; and serious adverse events was 5.7%. When compared with white children, black children had 3.43 times the odds of dying with the 30 days following surgery. They also had 18% relative greater odds of having postoperative complications and 7% relative higher odds of serious adverse events.

The researchers did underscore some of the limitations of their study. This includes the fact that the American Society of Anesthesiologists physical status is not meant to predict postoperative mortality or morbidity and that surgeons could downgrade the score. They also didn’t analyze the site of care where the surgeries occurred because the database discourages identifying hospitals.

They concluded that black children were linked to a higher risk of complications and mortality following an operation, even in children who are apparently healthy. They underscore that the findings do not represent causality between race and postsurgery complications, but that there is a strong association.

Reference

1. Nafiu OO, Mpody C, Kim SS, Uffman JC, Tobias JD. Race, Postoperative complications, and death in apparently healthy children. Pediatrics. July 20, 2020. Epub ahead of print. doi:10.1542/peds.2019-4113