Washington (AFP)

A study of tens of thousands of children operated on in the United States shows that black children have a 3.5 times higher risk of dying from an operation than white children.

The analysis, carried out by researchers at Nationwide Children's Hospital in Ohio and published by the Journal of the American Pediatric Association on Monday, looked only at children who were relatively healthy at the time of the operation. that is to say without chronic disease or other risk factor, because it is shown that black people in the United States, overall have more "comorbidities" than white people, which increases the general risk of death.

Here, the researchers wanted to check whether, even in healthy patients, their postoperative state differed. The answer, in 172,549 patients between 2012 and 2017, is yes.

Very few children admittedly died within 30 days of their operation, according to data from 186 hospitals: 23 white and 13 black. But in proportion, the mortality was 0.02% in white children, and 3.5 times higher in black children: 0.07%.

Researchers also found that black children were more likely to experience postoperative complications (13.8% of white children, and 16.9% of black children) as well as serious adverse events such as cardiac arrest or reoperation.

The question that the study does not answer is: why?

The authors list a list of potential causes, both medical, social, and economic, as racial health disparities have been studied for decades in the United States, where skin color (which Americans call "race") is part of every statistic and is still closely related to socioeconomic status: higher propensity of African Americans to develop complications; communication problems with the medical profession; conscious or unconscious racism of doctors; poverty and limited access to health care.

No doubt also black children seek treatment in hospitals of lower quality: those who are in the neighborhoods where they live. And maybe doctors are less willing to recognize a medical problem in black patients than in white, as other studies have shown, especially for pain recognition.

As often in this type of large posteriori analyzes, the authors do not conclude on a cause and effect relationship, but they are certain that the problem has multiple causes.

"These findings could fuel preoperative conversations about risk, and help authors of future studies to elucidate the underlying mechanisms of racial differences in postoperative outcomes in children," they conclude.

© 2020 AFP