J Surg Res
. 2022 Sep 22;281:112-121.
doi: 10.1016/j.jss.2022.08.027. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/36155268/
Association Between Race, Gender, and Pediatric Postoperative Outcomes: An Updated Retrospective Review
Jordan E Jackson 1, Ganesh Rajasekar 2, Olivia Vukcevich 1, Brian A Coakley 3, Miriam Nuño 2, Payam Saadai 4
- PMID: 36155268
- DOI: 10.1016/j.jss.2022.08.027
Introduction: There has not been a recent evaluation of the association between racial and gender and surgical outcomes in children. We aimed to evaluate improvements in race- and gender-related pediatric postoperative outcomes since a report utilizing the Kids’ Inpatient Database data from 2003 to 2006.
Methods: Using Kids’ Inpatient Database (2009, 2012, 2016), we identified 245,976 pediatric patients who underwent appendectomy for acute appendicitis (93.6%), pyloromyotomy for pyloric stenosis (2.7%), empyema decortication (1.6%), congenital diaphragmatic hernia repair (0.7%), small bowel resection for intussusception (0.5%), or colonic resection for Hirschsprung disease (0.2%). The primary outcome was the development of postoperative complications. Multivariable logistic regression was used to evaluate risk-adjusted associations among race, gender, income, and postoperative complications.
Results: Most patients were male (61.5%) and 45.7% were White. Postoperative complications were significantly associated with male gender (P < 0.0001) and race (P < 0.0001). After adjustment, Black patients were more likely to experience any complication than White patients (adjusted odds ratio 1.3, confidence interval 1.2-1.4), and males were more likely than females (adjusted odds ratio 1.3, confidence interval 1.2-1.4).
Conclusions: No clear progress has been made in eliminating race- or gender-based disparities in pediatric postoperative outcomes. New strategies are needed to better understand and address these disparities.
Keywords: Gender; Postoperative morbidity; Race.
Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.