Study: Healthy black children die more often after surgery than white children

Within 30 days of their surgery, black children were at greater risk of complications and death than white children, and nearly 3.5 times more likely to die within that period New research It was published in Pediatrics magazine on Monday.

It is well known that black people have High defect rate After surgery than their white counterparts. The predominant cause of these disparities may be the pre-operative black adult’s increased incidence of chronic illness—potential prejudice and other potential factors such as structural racism. in addition.

The existence of these same disparities between different races of healthy children, who are expected to be at low risk, has not previously been studied. Previous related work on children included analysis of people with more serious illnesses and disabilities.

Even in healthy black children, its complications and deaths still occur at a high rate compared to the white peers in the study, and preoperative illness is not the only factor leading to postoperative unhappiness. The researchers said.

“Healthy children have a lower incidence of complications,” said Dr. Olubukola Nafiu, lead author of the study, a pediatric anesthesiologist, and vice chair of academic and research at Nationwide Children’s Hospital. Press release..

“The expectation is that the comorbidity and mortality rates of healthy children do not vary by race category.

“These findings aren’t surprising, but they are horrifying and unacceptable,” said Nearhard Garris, a pediatrician in Chicago who chairs the American Academy of Pediatrics Minority Health, Equity, and Inclusion Committee. Said the doctor.

“It’s miserable to think of a child who has died after surgery. However, a child who is sick or mild before surgery and who has complications, adverse events, or even death needs immediate attention and action. Yes,” said Hard Garris, who was not involved in the study.

Black is “not a problem,” which adds to the health care gap, she added. “How our society treats, discriminates and denies fairness against African Americans and other people of color encapsulates the problem and the excuse for death.”

High risk of complications and death

In addition to being at high risk of dying within 30 days, black children were 18% more likely to develop complications. These children are also 7% more likely to develop “serious adverse events”, especially bleeding requiring transfusion, Sepsis -Organ malfunction, shock, death as a result of the body’s response to harmful bacteria and viruses in blood and tissues.

In addition, black children were at increased risk of having a second surgery or intubation that was not part of the plan.

The children studied were younger than 17 years old and were part of the National Surgical Quality Improvement Program-Pediatric Database 2012-2017. This program is generally a reporting system designed to collect the results of children undergoing surgery at various medical settings in the United States.

The children included were those who underwent hospital surgery and ranged from normal health to children suffering from mild illnesses such as seizure disorders. Children of both races had milder illnesses than being completely healthy and had similar pre-operative incidences of various disorders and diseases.

Among 172,549 children, the overall incidence of death, postoperative complications, and other serious adverse events such as heart attack, sepsis, readmission, and reoperation was low.

The results of the study are “anxiety,” but important. Because they “further explain how racism in this country shapes health outcomes,” said Liaboid, a pediatrician in California. She was not involved in the study.

“Racism, not race, is an important determinant of health,” Boyd added. “Racism makes people sick and contributes to premature death even for our children.”

Many factors can affect postoperative health, including racism

Higher mortality rates in black children may be explained by the likelihood of serious adverse events following surgery, according to studies.

The researchers lacked details about the quality of hospitals in which these children had surgery because the databases analyzed in the current study did not identify a particular hospital. Influence communication, Decision making The patient was also unknown.

Apart from the pre-operative disease, poverty, Lack of access to health care and other resources, and biological predisposition are all considered probable causes of complications and postoperative mortality, Related research Most adults showed.

“As the study points out, previous data showed that insurance status determines American care and sometimes racial segregation,” Boyd said. “Thus, we need to know whether hospital isolation contributes to this outcome due to poor hospital quality, thanks to isolation.”

Other factors such as communication Between doctor and patient bias Studies show that amongst health care providers, people of different races influence post-operative health.

Researchers have warned that their findings are from observed data. “Race does not cause these consequences, but it is strongly associated with them,” Nafiu said.

The researchers’ next task is to find out what causes postoperative complications that are causing the pattern of illness and death, and help them determine what can help.