Black Children Face Higher Risk of Death After Surgery

A study, "Race, Preoperative Risk Factors, and Death After Surgery," to be published in the February 2018 issue of Pediatrics found that black children are more than twice as likely to die following surgery than white children, and suggests a race-specific model to predict surgical outcomes. The study, to be published online Jan. 10, examined 30-day postoperative mortality for more than 260,000 surgical procedures performed for children from 2012 to 2015. The authors developed race-specific models using preoperative risk factors to predict 30-day surgical mortality for black children versus white children. They found a higher prevalence of risk factors for black children that include ventilator use, oxygen support, wound infections, transfusions, and neonatal status. The authors state that they did not seek to assign or understand the cause of the increased risks of death following surgery. They suggest that race-specific models could more accurately identify patients at high risk for death following surgery, as compared with models that examine all races grouped together. The authors suggest that interventions to decrease risks of death after surgery be tested within the context of race-specific risk strata to reduce the surgical mortality rate in black children.

Editor's Note: A related commentary, "Surgical Mortality and Race as a Risk Factor: A Compass, Not a Destination," will also be published in the February 2018 Pediatrics.

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The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds