Sarah Tariq1, Madiha Syed2, Timothy Martin3, Xu Zhang4, Michael Schmitz5. 1. From the Department of Anesthesiology, The University of Texas Health Science Center at Houston, Houston, Texas. 2. Department of Anesthesiology, Cleveland Clinic, Cleveland, Ohio. 3. Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, Florida. 4. Center for Clinical and Translational Sciences, The University of Texas Health Science Center at Houston, Houston, Texas. 5. Department of Pediatric Anesthesiology, Arkansas Children's Hospital, Little Rock, Arkansas.
Abstract
BACKGROUND: Perioperative respiratory adverse events (PRAEs) account for the major cause of morbidity and mortality in children undergoing general anesthesia. In our institutional clinical practice, we suspected that African American children experienced untoward respiratory events more frequently than other racial groups. Identification of high-risk groups can guide decision making in the perioperative period, and aggressive optimization of specific care can enhance safety and improve outcomes. METHODS: Data came from a retrospective chart review for records from August 2013 to December 2013. The primary aim was to compare the incidence of PRAEs among racial groups of young children at a single institution. We also analyzed factors that are potentially associated with a higher risk of PRAEs. There were 1148 records that met the inclusion criteria. Racial identities, PRAEs, and risk factors were identified. Logistic regression analysis was performed to evaluate differences in PRAEs among racial groups controlling for confounding variables. RESULTS: Of all 1148 patients, 62 (5.4%) had a PRAE. African American children had significantly higher incidences of PRAE (26/231, 11.4%) compared to Caucasian (27/777, 3.5%; P < .001). Although the most common PRAE was laryngospasm, bronchospasm was the most common PRAE for African American children. Otolaryngology procedures were most commonly associated with PRAEs, followed by orthodontic procedures. CONCLUSIONS: In a multivariable logistic analysis, African American pediatric patients were shown to have significantly higher odds of PRAEs when compared with the Caucasian group.
BACKGROUND: Perioperative respiratory adverse events (PRAEs) account for the major cause of morbidity and mortality in children undergoing general anesthesia. In our institutional clinical practice, we suspected that African American children experienced untoward respiratory events more frequently than other racial groups. Identification of high-risk groups can guide decision making in the perioperative period, and aggressive optimization of specific care can enhance safety and improve outcomes. METHODS: Data came from a retrospective chart review for records from August 2013 to December 2013. The primary aim was to compare the incidence of PRAEs among racial groups of young children at a single institution. We also analyzed factors that are potentially associated with a higher risk of PRAEs. There were 1148 records that met the inclusion criteria. Racial identities, PRAEs, and risk factors were identified. Logistic regression analysis was performed to evaluate differences in PRAEs among racial groups controlling for confounding variables. RESULTS: Of all 1148 patients, 62 (5.4%) had a PRAE. African American children had significantly higher incidences of PRAE (26/231, 11.4%) compared to Caucasian (27/777, 3.5%; P < .001). Although the most common PRAE was laryngospasm, bronchospasm was the most common PRAE for African American children. Otolaryngology procedures were most commonly associated with PRAEs, followed by orthodontic procedures. CONCLUSIONS: In a multivariable logistic analysis, African American pediatric patients were shown to have significantly higher odds of PRAEs when compared with the Caucasian group.