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Race, Ethnicity, and Pediatric Postsurgical Mortality: Current Trends and Future Projections.
Nafiu, Olubukola O; Mpody, Christian; Aina, Titilopemi A; Ehie, Odinakachukwu; Tobias, Joseph D; Best, Ana F.
Afiliación
  • Nafiu OO; Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio.
  • Mpody C; Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio.
  • Aina TA; Department of Anesthesiology Perioperative and Pain Medicine, Baylor College of Medicine.
  • Ehie O; Division of Pediatric Anesthesia, Department of Anesthesia and Perioperative Care, University of California, San Francisco, California.
  • Tobias JD; Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio.
  • Best AF; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Pediatrics ; 154(2)2024 Aug 01.
Article en En | MEDLINE | ID: mdl-39069821
ABSTRACT

BACKGROUND:

No study has contextualized the aggregate human costs attributable to disparities in pediatric postsurgical mortalities in the United States, a critical step needed to convey the scale of racial inequalities to clinicians, policymakers, and the public.

METHODS:

We conducted a population-based study of 673 677 children from US hospitals undergoing intermediate to high-risk surgery between 2000 and 2019. We estimated the excess deaths that could be avoided if Black and Hispanic children had comparable mortality rates to white children. We estimated the mortality reduction required to eliminate disparities within the next decade. We finally evaluated the impact of policy changes targeting a modest annual 2.5% reduction in disparity-attributable mortality.

RESULTS:

During 2000 to 2019, risk-adjusted postoperative mortality trended consistently higher for both Black (adjusted RR [aRR] 1.42, 95% confidence interval [CI] 1.36-1.49) and Hispanic children (aRR 1.22, 95% CI 1.17-1.27) than for white children. These disparity gaps were driven by higher mortality in Black and Hispanic children receiving surgery in nonteaching hospitals (Black versus white aRR 1.63, 95% CI 1.38-1.93; Hispanic versus white aRR 1.50, 95% CI 1.33-1.70). There were 4700 excess deaths among Black children and 5500 among Hispanic children, representing. 10 200 (average 536 per year) excess deaths among minoritized children. Policy changes achieving an annual 2.5% reduction in postoperative mortality would prevent approximately 1100 deaths among Black children in the next decade.

CONCLUSIONS:

By exploring the solution, and not just the problem, our study provides a framework to reduce disparities in pediatric postoperative mortality over the next decade.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hispánicos o Latinos Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: America do norte Idioma: En Revista: Pediatrics Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hispánicos o Latinos Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Región como asunto: America do norte Idioma: En Revista: Pediatrics Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos