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Racial Disparities in Pediatric Endoscopic Sinus Surgery
Author(s) -
Pecha Phayvanh P.,
Hamberis Alexandra,
Patel Terral A.,
Melvin Cathy L.,
Ford Marvella E.,
Andrews Anne L.,
White David R.,
Schlosser Rodney J.
Publication year - 2021
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.29047
Subject(s) - medicine , interquartile range , confidence interval , odds ratio , logistic regression , cohort , incidence (geometry) , ethnic group , rate ratio , surgery , physics , sociology , anthropology , optics
Objective To determine the impact of race and ethnicity on 30‐day complications following pediatric endoscopic sinus surgery (ESS). Study Design Cross‐sectional cohort study. Subjects and Methods Patients ≤ 18 years of age undergoing ESS from 2015 to 2017 were identified in the Pediatric National Surgical Improvement Program‐Pediatric database. Patient demographics, comorbidities, surgical indication, and postoperative complications were extracted. Patient race/ethnicity included non‐Hispanic black, non‐Hispanic white, Hispanic, and other. Multivariable logistic regression was performed to determine if race/ethnicity was a predictor of postoperative complications after ESS. Results A total of 4,337 patients were included in the study. The median age was 10.9 (interquartile range: 14.5–6.7) years. The cohort was comprised of 68.3% non‐Hispanic white, 13.9% non‐Hispanic black, 9.7% Hispanic, and 2.1% other. The 30‐day complication rate was 3.2%, and the mortality rate was 0.3%. The rate of reoperation was 3.8%, and readmission was 4.1%. Black and Hispanic patients had higher rates of urgent operations ( P = .003 and P < .001, respectively), and black patients had a higher incidence of emergent operations ( P < .001) compared to their white peers. For elective ESS cases, multivariable analysis adjusting for sex, age, comorbidities, and surgical indication indicated that children of Hispanic ethnicity had increased postoperative complications (odds ratio: 1.57, 95% confidence interval: 1.04–2.37). Conclusion This analysis demonstrated that black and Hispanic children disproportionately undergo more urgent and emergent ESS. Hispanic ethnicity was associated with increased 30‐day complications following elective pediatric ESS. Further studies are needed to elucidate potential causes of these disparities and identify areas for improvement. Level of Evidence 3 Laryngoscope , 131:E1369–E1374, 2021