The effect of race and gender on pediatric surgical outcomes within the United States.

Stone ML, Lapar DJ, Kane BJ, Rasmussen SK, McGahren ED, Rodgers BM.

Source

Department of Surgery, The University of Virginia, Charlottesville, VA, USA.

Abstract

PURPOSE:

The purpose of this study was to examine risk-adjusted associations between race and gender on postoperative morbidity, mortality, and resource utilization in pediatric surgical patients within the United States.

METHODS:

101,083 pediatric surgical patients were evaluated using the U.S. national KID Inpatient Database (2003 and 2006): appendectomy (81.2%), pyloromyotomy (9.8%), intussusception (6.2%), decortication (1.9%), congenital diaphragmatic hernia repair (0.7%), and colonic resection for Hirschsprung's disease (0.2%). Patients were stratified according to gender (male: 63.1%, n=63,783) and race: white (n=58,711), Hispanic (n=26,118), black (n=9,103), Asian (n=1,582), Native American (n=474), and other (n=5,096). Multivariable logistic regression modeling was utilized to evaluate risk-adjusted associations between race, gender, and outcomes.

RESULTS:

After risk adjustment, race was independently associated with in-hospital death (p=0.02), with an increased risk for black children. Gender was not associated with mortality (p=0.77). Postoperative morbidity was significantly associated with gender (p<0 .001="" and="" associated="" dependent="" further="" gender="" hospital="" importantly="" increased="" length="" of="" on="" operation="" p="" race="" results="" stay.="" these="" type.="" were="" with="">

CONCLUSION:

Race and gender significantly affect postoperative outcomes following pediatric surgery. Black patients are at disproportionate risk for postoperative mortality, while black and Hispanic patients have increased morbidity and hospital resource utilization. While gender does not affect mortality, gender is a determinant of both postoperative morbidity and increased resource utilization.
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