Examining the racial and ethnic disparities in pediatric surgery using the surgical Desirability of Outcome Ranking (DOOR).

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-08-14 DOI:10.1016/j.amjsurg.2025.116580

Ikemsinachi C Nzenwa, Michael A Kochis, Alyssa Stetson, Carolyn J Reuland, Maimouna O Sy, David C Chang, Tawakalitu O Oseni, Cornelia L Griggs

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引用次数: 0

Abstract

Introduction: The Desirability of Outcome Ranking (DOOR) ranks multiple postoperative outcomes, potentially enhancing detection of risks influenced by social determinants of health. We examined the relationship between race, ethnicity, and DOOR scores in pediatric surgical patients.

Methods: Using NSQIP-Pediatric 2012-2022, we identified patients (≤18 years) who underwent general, urological, and gynecological surgery. DOOR scores range from 1 (most desirable) to 6 (least desirable). Ordinal logistic regression assessed associations with race, ethnicity and DOOR scores.

Results: Among 368,190 patients (64.3 % non-Hispanic White, 18.2 % Hispanic, 13.4 % non-Hispanic Black, 3.7 % non-Hispanic Asian, and 0.4 % non-Hispanic Native), Black patients had increased odds of higher DOOR scores (OR 1.06, 95 % CI 1.04-1.10), while Hispanic patients had decreased odds of high DOOR scores (OR 0.89, 95 % CI 0.86-0.92). In general and non-elective surgery, Black race was still significantly associated with higher DOOR scores.

Conclusions: Black children faced greater odds of undesirable outcomes. Future work may inform equitable, targeted interventions.

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使用手术结果排序（DOOR）检查儿科外科的种族和民族差异。

结果排序的可取性（DOOR）对多种术后结果进行排序，潜在地增强了对受健康社会决定因素影响的风险的检测。我们研究了儿科外科患者的种族、民族和DOOR评分之间的关系。方法：使用NSQIP-Pediatric 2012-2022，我们确定了接受普通外科、泌尿外科和妇科手术的患者（≤18岁）。DOOR得分范围从1（最理想）到6（最不理想）。有序逻辑回归评估了种族、民族和DOOR得分之间的关系。结果：在368,190例患者中（64.3%的非西班牙裔白人，18.2%的西班牙裔，13.4%的非西班牙裔黑人，3.7%的非西班牙裔亚洲人和0.4%的非西班牙裔原住民），黑人患者获得较高DOOR评分的几率增加（OR 1.06, 95% CI 1.04-1.10），而西班牙裔患者获得较高DOOR评分的几率降低（OR 0.89, 95% CI 0.86-0.92）。在一般和非选择性手术中，黑人种族仍然与较高的DOOR评分显著相关。结论：黑人儿童面临更大的不良后果的可能性。未来的工作可能会为公平、有针对性的干预措施提供信息。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.