WASHINGTON, dc | A study of tens of thousands of children operated in the United States shows that black children have a risk of dying following an operation 3.5 times higher than white children.
The analysis, conducted by researchers at the Nationwide Children’s Hospital in Ohio and published Monday by the journal of the american association of pediatrics, is only interested in the children in relatively good health at the time of the transaction, that is to say, without a chronic condition or other risk factor, because it is proven that black people, in the United States, have generally more of the “comorbidities” that the white people, which increases the overall risk of mortality.
Here, the researchers wanted to verify if, even in healthy patients, status post-operative differed. The answer, at 172 549 patients between 2012 and 2017, is yes.
Very few children are certainly dead in the first 30 days of operation, according to data from 186 hospitals: 23 white and 13 black. But in proportion, the mortality was 0.02% for white children and 3.5 times higher among black children: 0.07 per cent.
The researchers also found that black children were more often postoperative complications (13.8% of white children, and 16.9% of black children) and serious adverse events such as cardiac arrest or a new operation.
The question that the study does not answer is: why?
The authors enumerate a list of potential causes, both medical, social and economic, because the racial disparities for health has been studied for decades in the United States, where the color of the skin (as the Americans call ” race “) is part of any statistics and is still closely linked to the socio-economic status: a propensity superior to Afro-Americans to develop complications; the problems of communication with the medical body; the conscious racism or unconscious doctors; poverty and limited access to health care.
Without a doubt as the black children are they treated in hospitals of less good quality: those who are in the neighborhoods where they live. And it may be that doctors are less willing to recognize a medical problem in black patients than white, as other studies have shown, particularly for the recognition of pain.
As often in this type of great analysis in hindsight, the authors do not conclude on a causal link, but they are certain that the problem has multiple causes.
“These results could contribute to the conversations pre-operative risk, and assist the authors of future studies to elucidate the underlying mechanisms of racial differences in postoperative outcomes of children,” they concluded.