Are Black Children More Likely to Die After Surgery Than White Children?

According to the Centers for Disease Control and Prevention, there is increasing evidence that certain racial and ethnic minority groups are disproportionately affected by COVID-19, suffering more severe health issues and higher mortality rates. In light of the current health crisis, a recent study comparing postsurgical outcomes between Caucasian and Black children is especially disturbing.

In a new study entitled Race, Postoperative Complications, and Death in Apparently Healthy Children and published in the August 2020 issue of Pediatrics, the authors conducted a retrospective analysis of 172,549 presumably healthy children who underwent inpatient operations at hospitals across the country from 2012 through 2017.

The data showed that compared with their white peers, African-American children had 3.43 times the odds of dying within 30 days following surgery. They also had 18 percent higher chances of developing postoperative complications and seven percent relative higher odds of developing serious adverse events (SAE) – cardiac arrest, sepsis, readmission, or reoperation – following surgery.

Other studies and data previously demonstrated that African-American patients have poorer surgical outcomes compared with their white peers. This study challenges one common explanation that Black patients have more pre-existing health conditions that contribute to worse results. Because the study reviewed the outcomes of cases involving children all considered generally healthy before surgery, it provides evidence against that presumption.

Identifying Explanations and Working to Improve Outcomes

This study does not explain why Black children seem more likely to die or experience more negative outcomes than their white counterparts. However, it notes that issues such as poverty, lack of access to healthcare and other resources, and biological predisposition may be factors. The authors also acknowledge that they could not identify and analyze whether the site of care was a significant factor in the discrepancy, i.e., whether more African-American patients received care at lower-quality hospitals.

It does identify one possible factor in the higher mortality rates they observed among African-American children: a higher likelihood of SAEs. Since these postoperative complications are often fatal, taking additional steps to prevent and treat SAEs proactively may help reduce the overall postsurgical fatality rate among Black patients.

Understanding the reasons for disparities in medical care is one step towards improving outcomes. The authors note that:

In any case, racial disparity in health care outcomes is a multifactorial challenge that encompasses the interface of patient factors, family dynamics, social determinants, health care provider factors, and hospital variables. To be effective, efforts to reduce disparity in health outcomes (including postsurgical morbidity and mortality) will have to be multipronged.

What Recourse Do Patients Have?

All patients deserve quality pre-operative, surgical, and postoperative care. If you believe you or your child has received substandard care or been the victim of a medical or surgical error, please contact the attorneys in Sommers Schwartz’s Medical Malpractice Litigation group. Professional negligence lawsuits are one way to help ensure that hospitals and medical providers prioritize patient health regardless of a patient’s race or demographics.