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Race/Ethnicity and Duration of Anesthesia for Pediatric Patients in the US: a Retrospective Cohort Study

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Abstract

Background

Previous literature has demonstrated adverse patient outcomes associated with racial/ethnic disparities in health services. Because patients/parents and providers care about the duration of anesthesia, this study focuses on this outcome.

Objectives

To determine the association between race/ethnicity and duration under anesthesia.

Research Design

In this retrospective cohort study of data from the Multicenter Perioperative Outcomes Group, White non-Latino was the reference and was compared with Black non-Latino children, Latino, Asian, Native American, Other, and “Unknown” race children.

Subjects

Children aged 3 to 17 years.

Outcomes

Induction duration (primary outcome), procedure-end duration, and total duration under anesthesia (secondary outcomes).

Results

Of 37,596 eligible cases, 9,610 cases with complete data were analyzed. The sample consisted of 6,894 White non-Latino patients, 1,021 Black non-Latino patients, 50 Latino patients, 287 Asian patients, 26 Native American patients, 57 “Other” race patients, and 1,275 patients of “Unknown” race. The mean induction time was 11.9 min (SD 5.6 min). In adjusted analysis, Black non-Latino patients had 5% longer induction and procedure-end durations than White non-Latino children (exponentiated beta coefficient [Exp (β)] 1.05, 95% CI: 1.02–1.08, p < 0.01 and Exp (β) 1.08, 95% CI 1.04–1.13, p < 0.01 respectively).

Conclusions

White non-Latino children had shorter induction and procedure-end durations than Black children. The differences in induction and procedure-end time were small but may be meaningful on a population-health level.

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Notes

  1. We submitted our research proposal to study three cohorts of patients in August 2018 and received data for one cohort in April 2019.

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Acknowledgements

The authors gratefully acknowledge David A. August, MD PhD, Instructor at Massachusetts General Hospital, 55 Fruit Street Boston, MA, USA, and Erik Shank MD, South Shore Health 55 Fogg Road, South Weymouth, MA, USA. Both Drs. August and Shank are senior pediatric anesthesiologists who provided clinical expertise.

Funding

Dr. Rosenbloom’s work was supported by the National Institutes of Health (T32 GM007592 grant, Research Training for Anesthetists) and by the President and Fellows of Harvard College (Eleanor and Miles Shore 50th Anniversary Fellowship Program for Scholars in Medicine). All other support was provided from institutional and/or departmental sources. Funding for MPOG was provided by departmental and institutional resources at each contributing site. In addition, partial funding to support underlying electronic health record data collection into the Multicenter Perioperative Outcomes Group registry was provided by Blue Cross Blue Shield of Michigan/Blue Care Network as part of the Blue Cross Blue Shield of Michigan/Blue Care Network Value Partnerships program.

Author information

Authors and Affiliations

  1. Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, USA

    Julia M. Rosenbloom, Hao Deng, Ariel L. Mueller & Timothy T. Houle

  2. Disparities Research Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Margarita Alegria

  3. Departments of Medicine and Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Margarita Alegria

Authors
  1. Julia M. Rosenbloom
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  2. Hao Deng
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  3. Ariel L. Mueller
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  4. Margarita Alegria
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  5. Timothy T. Houle
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Consortia

Collaborators from the Multicenter Perioperative Outcomes Group

Contributions

All authors contributed to the study conception and design. Material preparation, data conditioning, and analysis were performed by Drs. Julia M. Rosenbloom and Hao Deng and supervised by Dr. Timothy Houle. The first draft of the manuscript was written by Dr. Julia M. Rosenbloom and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Julia M. Rosenbloom.

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This article does not contain any studies with human participants or animals performed by any of the authors.

Conflict of Interests

The authors declare no competing interests.

Disclaimer

Although Blue Cross Blue Shield of Michigan/Blue Care Network and Multicenter Perioperative Outcomes Group work collaboratively, the opinions, beliefs, and viewpoints expressed by the authors do not necessarily reflect the opinions, beliefs, and viewpoints of Blue Cross Blue Shield of Michigan/Blue Care Network or any of its employees.

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Rosenbloom, J.M., Deng, H., Mueller, A.L. et al. Race/Ethnicity and Duration of Anesthesia for Pediatric Patients in the US: a Retrospective Cohort Study. J. Racial and Ethnic Health Disparities 10, 1329–1338 (2023). https://doi.org/10.1007/s40615-022-01318-2

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