Black kids more likely to die after surgery than whites: study

Black children were more than three times likely to die after common surgeries than whites although deaths among patients overall were rare, a new study found.

A team of researchers examined national data on operations of nearly 173,000 children from 2012 through 2017, of which 11% of the children were Black and 70% were white.

Although there were few deaths, the data revealed large disparities: 23 Black children died within 30 days of surgery compared to 13 whites, even though the Black children made up the minority of the study participants.

The most common surgeries included in the study, which was published Monday in the medical journal Pediatrics, were appendix removal and orthopedic operations.

Compared to their white counterparts, Black children also had an 18% greater chance of developing postoperative complications and 7% higher chance of experiencing serious adverse health events such as cardiac arrest or readmission.

Overall, there was a 14% chance for postoperative complications and almost a 6% chance of serious adverse events among the thousands of study participants.The 30-day mortality rate for white children was 0.02% and 0.07% for Blacks, according to the study.

“Despite ongoing improvements in surgical care and apparent rarity of postsurgical mortality, racial and ethnic disparities in postoperative morbidity and mortality remain significant and persistent,” the researchers wrote in their study.

“That African American patients have poorer health outcomes than their white peers is not novel. Several investigators have shown that African American patients of all age groups are more likely to suffer postsurgical complications and die after surgery than their white peers.”

The children included in the study were younger than 17 and considered relatively healthy before their surgeries. Pre-existing conditions were uncommon, although Black children had slightly more heart and digestive problems.

Those differences don’t fully explain the results, Dr. Olubukola Nafiu of Nationwide Children’s Hospital in Columbus, Ohio, the study’s lead author, told The Associated Press.

While other research has suggested that differences in hospital quality and doctor bias contribute to racial health inequities, Dr. Nafiu said those factors are not within the study’s scope, noting reasons for the disparities found are uncertain.

Racial disparity in health care also has been attributed to factors such poverty, lack of access to resources, biological predisposition and a higher comorbidity burden among Blacks, the study authors note.

An editorial in Pediatrics says the research should prompt doctors and hospitals to confront their own biases, while citing a previous study that shows doctors “with greater implicit bias” were more likely to prescribe narcotic medications for post-surgery pain for white children than for Blacks.

The COVID-19 pandemic also has highlighted racial disparities in health care, disproportionately affecting Blacks and other minorities. Data from the Centers for Disease Control and Prevention suggest that Black people have a hospitalization rate that is five times higher than their white counterparts.

“We have two crises going on at the same time. We have the unprecedented coronavirus pandemic as well as extraordinary racial tensions after the terrible killing of George Floyd,” Roger Severino, director of the Office for Civil Rights at the Department of Health and Human Services, said Monday during a media conference call. “So now more than ever, we need to redouble efforts to make sure that no one gets left behind when it comes to provision of health care services.”

Research also has shown that Black children with cancer are more likely to die after admission to the pediatric intensive care units than whites.

⦁ This article is based in part on wire service reports.