A recent study, Race, Preoperative risk factors, and death after surgery, has found that black children are more than twice are at higher risk of death than white children and describes race-specific models to predict surgical results. The study has been published online on the issue of Pediatrics and will be published in the February 2018.
Authors Oguz Akbilgic PhD, assistant professor at the University of Tennessee Health Science Center (UTHSC), Max Langham, MD, a pediatric surgeon at Le Bonheur Children’s Hospital and professor of surgery and pediatrics and vice chairman of the Department of Surgery at UTHSC, and Robert Davis, MD, MPH, Governor’s chair and professor and founding director of UTHSC-ORNL Center for Biomedical Informatics analysed 30-day postoperative death for more than 260,000 surgical procedures performed for children from 2012 to 2015.
The information was compiled from American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database and includes patients from children’s hospitals from the country over. The authors developed race-specific models using preoperative risk components to predict 30-day surgical mortality for black children versus white children.
They found a higher pervasiveness of risk factors for poor results in dark youngsters that include ventilator use, oxygen support, wound infections, transfusions and neonatal status. The authors state that while they didn’t look to assign or understand the reason for the increased risks of death following surgery, the use of race-specific models could more precisely identify patients at high risk for death following surgery as compared and models that analyze all races grouped together.
They suggest that interventions reduce risks of death after surgery be tested within the context of race-specific risk strata to decrease the surgical death rate in black children. Department Chair and pediatrician-in-chief Jonathan A. McCullers, MD considers this to be an important milepost on the road to eliminating health disparities in surgical results.
“This information and the novel models derived from them will serve as critical tools to identify areas for intervention that we hope will eliminate with a few, if not all, of the disparities that arise from the poverty and limited access to comprehensive care for which dark race is a marker, not a reason.”