Association Between Race, Gender, and Pediatric Postoperative Outcomes: An Updated Retrospective Review

Jackson, Jordan E.; Rajasekar, Ganesh; Vukcevich, Olivia; Coakley, Brian A.; Nuño, Miriam A; Saadai, Payam

doi:10.1016/j.jss.2022.08.027

Cited by 4 publications

(7 citation statements)

References 43 publications

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“…Although our relationship with the patient often ends soon after surgery, it is imperative to understand the implications of a patient’s race on their surgical course. In a recent study that used a national cohort of 250,000 pediatric general surgery patients in the Kids’ Inpatient Database, race was significantly associated with surgical morbidity, with Black patients having the highest complication rate (6.1%), followed by Hispanics (4.4%), and then Whites (4.3%) [ 69 ]. The Kids’ Inpatient Database (KID) is a sample of pediatric discharges in states participating in the Healthcare Cost and Utilization Project (HCUP).…”

Section: Postoperative Racial Disparitiesmentioning

confidence: 99%

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Racial Inequity in Pediatric Anesthesia

Willer

Mpody

Nafiu

2023

Curr Anesthesiol Rep

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Purpose of Review Minority health disparities have received renewed attention in the USA following several highly publicized racial injustices in 2020. Though the focus has been largely on adults, children are not immune to these inequities. By reviewing racial disparities in pediatric perioperative care, we aim to engage the anesthesia community in the fight against systemic racism. Recent Findings Minority children have higher rates of anesthetic and surgical morbidity compared to White children, including respiratory events, length of stay, hospital costs, and even death. These inequities occur across surgical specialties and environments. Summary Racial disparities in the perioperative health and management of children are ubiquitous. Herein, we will summarize recent pediatric health disparity literature, discuss some important contributors to persistent inequities, and propose avenues for anesthesiologists to impact the pursuit of equitable healthcare outcomes.

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Section: Postoperative Racial Disparitiesmentioning

confidence: 99%

“…Related to disparities in postoperative complications, many studies have demonstrated that minority children have prolonged length of stay following surgery [ 69 , 70 ]. Minority children may also incur longer preoperative hospital stays.…”

Section: Postoperative Racial Disparitiesmentioning

confidence: 99%

Racial Inequity in Pediatric Anesthesia

Willer

Mpody

Nafiu

2023

Curr Anesthesiol Rep

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“…Compared with adults, the pediatric population is at higher risk of complicated acute appendicitis, a reality which prolongs hospital stay [ 1 , 2 ]. The annual incidence of acute appendicitis is 19–28 per 10,000 for children under the age of 14, with an overall lifetime risk of 9% for males and 7% for females [ 3 , 4 ]. In the pediatric population, the incidence of acute appendicitis is highest between the ages of 12 and 17 years, with a peak incidence rate seen between the ages of 11 and 12 years [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…The annual incidence of acute appendicitis is 19–28 per 10,000 for children under the age of 14, with an overall lifetime risk of 9% for males and 7% for females [ 3 , 4 ]. In the pediatric population, the incidence of acute appendicitis is highest between the ages of 12 and 17 years, with a peak incidence rate seen between the ages of 11 and 12 years [ 3 , 4 ]. The rates of perforation are significantly higher in younger children compared to older children and adolescents [ 1 , 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the pediatric population, the incidence of acute appendicitis is highest between the ages of 12 and 17 years, with a peak incidence rate seen between the ages of 11 and 12 years [ 3 , 4 ]. The rates of perforation are significantly higher in younger children compared to older children and adolescents [ 1 , 3 , 4 ]. The lifetime probability of an appendectomy is 23% for females and 12% for males [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children

et al. 2023

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Aim of the study: To evaluate the clinical outcomes and complication rate of laparoscopic appendectomy in children operated on during the daytime versus nighttime. Methods: A total of 303 children who underwent laparoscopic appendectomy for acute appendicitis between 1 January 2020 and 31 December 2022 were enrolled in this retrospective study. The patients were divided into two study groups. The first group consisted of the patients who underwent laparoscopic appendectomy during the day shift from 07:00–21:00 (n = 171), while the patients in the second group underwent laparoscopic appendectomy during the night shift from 21:00–07:00 (n = 132). The groups were compared for baseline clinical and laboratory data, treatment outcomes, and complications. The Mann–Whitney U test was used to compare continuous variables, while the Chi-square test was used to compare categorical variables. A two-sided Fisher’s exact test was used when the frequency of events in a certain cell was low. All p values less than 0.05 were considered significant. Results: The proportion of complicated appendicitis was almost the same in both patient groups (n = 63, 36.8% vs. n = 49, 37.1%, p = 0.960). Out of the total number of patients presenting during the daytime and nighttime, 11 (6.4%) and 10 (7.6%) developed a postoperative complication, respectively (p = 0.697). Additionally, rates of readmission (n = 5 (2.9%) vs. n = 2 (1.5%); p = 0.703), redo-surgery (n = 3 (1.7%) vs. n = 0; p = 0.260), conversion to open surgery (n = 0 vs. n = 1 (0.8%); p = 0.435) and length of hospital stay (n = 3 (IQR 1, 5) vs. n = 3 (IQR 2, 5); p = 0.368) did not differ significantly between daytime and nighttime appendectomies. The duration of the surgery was significantly shorter in patients presenting during the day than in those presenting at night (26 min (IQR 22, 40) vs. 37 min (31, 46); p < 0.001). Conclusions: Different shift times did not affect the treatment outcomes or complication rates for children receiving laparoscopic appendectomy.

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