Racial Disparities in Postoperative Outcomes Following Operative Management of Pediatric Developmental Dysplasia of the Hip

Malyavko, Alisa; Quan, Theodore; Howard, Peter; Recarey, Melina; Manzi, Joseph E.; Tabaie, Sean

doi:10.1097/bpo.0000000000002102

Cited by 7 publications

(5 citation statements)

References 26 publications

(71 reference statements)

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“…grouped all URM patients into one cohort. They did not stratify their analysis for sub-groups, which may explain the differences in their findings compared to our study [18].…”

Section: Discussionmentioning

confidence: 64%

“…Malyavko et al analyzed 9159 patients who underwent surgical treatment for developmental dysplasia of the hip. Following multivariate analyses, the authors found that patients from underrepresented minority (URM) groups (African American or African American, Hispanic, Native American or Alaskan, and Native Hawaiian or Pacific Islander) had an increased risk for unplanned reintubation compared to white patients [18]. Similarly, Patel et al aimed to evaluate whether race influences the healing of osteochondritis dissecans (OCD) lesions in pediatric patients [9].…”

Section: Discussionmentioning

confidence: 99%

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Evaluating the association between race and complications following pediatric upper extremity surgery

Gupta

Palosaari

Quan

et al. 2023

Journal of Pediatric Orthopaedics B

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Race can influence perioperative care and outcomes in adult and pediatric orthopedic surgery. However, no prior study has evaluated any associations between race and complications following upper extremity surgery in pediatric patients. Thus, the purpose of this study was to evaluate whether there are any differences in risks for complications, readmission, or mortality following upper extremity surgery between African American and Caucasian pediatric patients. Pediatric patients who had a primary upper extremity procedure from 2012 to 2019 were identified in the National Surgical Quality Improvement Program-Pediatric database. Patients were categorized into two cohorts: patients who were Caucasian and patients who were African American. Differences in demographics, comorbidities, and postoperative complications were assessed and compared between the two-patient population using bivariate and multivariable regression analyses. Of the 25 848 pediatric patients who underwent upper extremity surgeries, 21 693 (83.9%) were Caucasian, and 4155 (16.1%) were African American. Compared to Caucasian patients, African American patients were more likely to have a higher American Society of Anesthesiologists classification (P < 0.001), as well as pulmonary comorbidities (P < 0.001) and hematologic disorders (P = 0.004). Following adjustment on multivariable regression analysis to control for baseline characteristics, there were no differences in any postoperative complications between Caucasian and African American patients. In conclusion, African American pediatric patients are not at an increased risk for postoperative complications compared to Caucasian patients following upper extremity surgery. Race should not be used independently when evaluating patient risk for postoperative complications. Level of Evidence: III.

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“…grouped all URM patients into one cohort. They did not stratify their analysis for sub-groups, which may explain the differences in their findings compared to our study [18].…”

Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Evaluating the association between race and complications following pediatric upper extremity surgery

Gupta

Palosaari

Quan

et al. 2023

Journal of Pediatric Orthopaedics B

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“…In their study, Noureldine et al reported a longer length of hospital stay, increased postoperative complications, and increased costs for Black patients compared to White patients after thyroid and parathyroid patients [19]. In that study, it was reported that African Americans had less access to intermediate and high-volume surgeons [16].…”

Section: Discussionmentioning

confidence: 95%

“…Another study found higher rates of respiratory events including laryngo/bronchospasm, pneumonia, pulmonary edema, intubation, prolonged intubation, and ventilation in Black children after tonsillectomy compared with children of other races [15]. Furthermore, Malyavko et al found that children from underrepresented minority groups had higher odds of undergoing unplanned reintubation compared with White children following surgical treatment of hip dysplasia [16].…”

Section: Discussionmentioning

confidence: 99%

Racial Differences in 30-Day Reintubation After Head and Neck Surgery

Burton¹,

Wall²,

Le³

et al. 2023

Cureus

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BackgroundThis study aimed to examine the association of race and ethnicity with 30-day unplanned reintubation following head and neck surgery. MethodologyA retrospective analysis of head and neck surgery patients aged greater than or equal to 18 years was extracted from the American College of Surgeons National Surgical Quality Improvement Program database from 2015 to 2020. Patient demographics, comorbidities, and 30-day reintubation were included in the analysis. Pearson's chi-square and independent samples t-test were used to compare reintubation cohorts. Multivariable logistic regression was used to identify the association of race and ethnicity with 30-day reintubation. ResultsOf the total 108,442 head and neck surgery cases included, 74.9% of patients were non-Hispanic White, 17.3% were non-Hispanic Black, and 7.7% were Hispanic. The overall 30-day reintubation rate was 0.33%. After adjusting for age, body mass index, sex, and comorbidities, non-Hispanic Black patients had increased 30-day reintubation compared to non-Hispanic White patients (odds ratio [OR] = 2.14, 95% confidence interval [CI] 1.70-2.69, and P < 0.0001). There was no difference in 30-day reintubation for Hispanic patients compared to non-Hispanic White patients (OR = 1.08, 95% CI 0.67-1.65, and P = 0.747). ConclusionsThis analysis showed that non-Hispanic Black patients disproportionately had higher odds of 30-day reintubation following head and neck surgery. Hispanic ethnicity was not associated with increased odds of 30-day reintubation. More studies are needed to investigate the reasons for these racial differences.

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“…These findings have been echoed across surgical specialties, with minority children incurring poorer outcomes. Minority children have a greater risk of postoperative pulmonary complications [ 70 – 73 ], cardiovascular complications, and cardiac arrest [ 70 , 73 ], surgical wound complications [ 61 ••, 73 ], unplanned reoperation [ 61 ••], and readmission [ 74 ]. Even more concerning, however, is disparate postoperative mortality rates.…”

Section: Postoperative Racial Disparitiesmentioning

confidence: 99%

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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Racial Disparities in Postoperative Outcomes Following Operative Management of Pediatric Developmental Dysplasia of the Hip

Cited by 7 publications

References 26 publications

Evaluating the association between race and complications following pediatric upper extremity surgery

Evaluating the association between race and complications following pediatric upper extremity surgery

Racial Differences in 30-Day Reintubation After Head and Neck Surgery

Racial Inequity in Pediatric Anesthesia

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