Racial disparities in readmission rates following surgical treatment of pediatric developmental dysplasia of the hip

Authors

Omar H. Tarawneh, School of Medicine, New York Medical College, 40 Sunshine Cottage Rd, Valhalla, NY, 10595, USA. otarawne@student.nymc.edu.
Theodore Quan, Department of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, 2300 M St, Washington DC, Washington, DC, 20037, USA.
Ivan Z. Liu, The Medical College of Georgia, Augusta University, 1120 15th St, GA, 30912, Augusta, USA.
Jordan Pizzarro, Department of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, 2300 M St, Washington DC, Washington, DC, 20037, USA.
Caillin Marquardt, Department of Orthopaedic Surgery, The George Washington University School of Medicine and Health Sciences, 2300 M St, Washington DC, Washington, DC, 20037, USA.
Sean A. Tabaie, Department of Orthopaedic Surgery, Children's National Hospital, 111 Michigan Avenue, Washington, NWDC, 20010, USA.

Document Type

Journal Article

Publication Date

2-28-2023

Journal

European journal of orthopaedic surgery & traumatology : orthopedie traumatologie

DOI

10.1007/s00590-023-03496-z

Keywords

Hip dysplasia; Pediatrics; Readmission; Risk factors; Surgical treatment

Abstract

PURPOSE: Across orthopedic subspecialties, significant racial disparities have been identified with regard to postoperative outcomes. Despite these findings among adult patients, the literature assessing these disparities within pediatric orthopedics is limited. The purpose of this study was to determine the independent predictors for unplanned readmission following surgical treatment of developmental dysplasia of the hip. METHODS: Pediatric patients undergoing hip dysplasia surgery from 2012 to 2019 were identified in the National Surgical Quality Improvement Program-Pediatric database. Two patient groups were defined: patients who had unplanned hospital readmission within 30 days of surgery and patients who were not readmitted. Clinical characteristics assessed included gender, race, and American Society of Anesthesiologists (ASA) class. Risk factors for complications were assessed using bivariate and multivariate analysis. RESULTS: Of 6561 pediatric patients undergoing surgical treatment for hip dysplasia, 540 (8.2%) had unplanned readmission. On bivariate analysis, non-white race (Black, Asian, Hispanic, American Indian, and Native Hawaiian), an ASA class of III, IV, or V, pulmonary, renal, neurological, and gastrointestinal comorbidities, as well as immune disease, steroid use, and nutritional support were significantly associated with unplanned readmission (p < 0.05 for all). After controlling for confounding variables on multivariate analysis, non-white race (OR 1.46; p = 0.042) and ASA class of III-V (OR 2.21; p = 0.002) were found to be independent predictors for readmission. CONCLUSION: Clinicians should be advised of the increased readmission rates observed in non-white patients and those of higher ASA scores. Further work is needed to combat existing disparities within pediatric orthopedics.

APA Citation

Tarawneh, Omar H.; Quan, Theodore; Liu, Ivan Z.; Pizzarro, Jordan; Marquardt, Caillin; and Tabaie, Sean A., "Racial disparities in readmission rates following surgical treatment of pediatric developmental dysplasia of the hip" (2023). GW Authored Works. Paper 2347.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/2347

Department

Orthopaedic Surgery