Why Are Healthy Black Kids More Likely to Die After Surgery?
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That African American (AA) patients have poorer surgical outcomes compared with abstract their white peers is established. The prevailing presumption is that these disparities operate within the context of a higher preoperative comorbidity burden among AA patients. Whether these racial differences in outcomes exist among apparently healthy children (traditionally expected to have low risk of postsurgical complications) has not been previously investigated.

Researchers performed a retrospective study by analyzing the National Surgical Quality Improvement Program–Pediatric database and identifying children who underwent inpatient operations and were assigned American Society of Anesthesiologists physical status 1 or 2. They used univariable and risk-adjusted logistic regression to estimate the odds ratios and their 95% confidence intervals (CIs) of postsurgical outcomes comparing AA to white children.

Results:
- Among 172549 apparently healthy children, the incidence of 30-day mortality, postoperative complications, and serious adverse events were 0.02%, 13.9%, and 5.7%,respectively.
- Compared with their white peers, AA children had 3.43 times the odds of dying within 30 days after surgery.
- Compared with being white, AA had 18% relative greater odds of developing postoperative complications and 7% relative higher odds of developing serious adverse events.

Conclusively, Even among apparently healthy children, being AA is strongly associated with a higher risk of postoperative complications and mortality. Mechanisms underlying the established racial differences in postoperative outcomes may not be fully explained by the racial variation in preoperative comorbidity.

Source: https://pediatrics.aappublications.org/content/pediatrics/early/2020/07/16/peds.2019-4113.full.pdf
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