Race, Postoperative Complications, and Death in Apparently Healthy Children

Olubukola O. Nafiu, MD, FRCA, MS, Christian Mpody, MD, PhD, MPH, MBA, Stephani S. Kim, MPH, PhD, Joshua C. Uffman, MD, MBA, Joseph D. Tobias, MD:

OUND: That African American (AA) patients have poorer surgical outcomes compared with 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.

METHODS: We performed a retrospective study by analyzing the National Surgical Quality Improvement Program–Pediatric database from 2012 through 2017 and identifying children who underwent inpatient operations and were assigned American Society of Anesthesiologists physical status 1 or 2. We 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.