ArticleBMJ (Clinical research ed.)2023
Inequities in surgical outcomes by race and sex in the United States: retrospective cohort study.
Article in BMJ (Clinical research ed.), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 36 citations in OpenAlex.
- Structural racism as a fundamental cause of health inequities: a scoping review.International journal for equity in health · 2025Pooled it
- Pooled it
- Racial disparities in the rate of same-admission cholecystectomy following biliary pancreatitis.Surgical endoscopy · 2026Article
- Surgical Decision Making Among Black Adults With Carpal Tunnel Syndrome.JAMA network open · 2026Article
- Racial and Sex Differences in Postoperative Mortality Between Patients With Versus Without Dementia.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Designing a Culturally Adapted Perioperative Mental Health Intervention for Older Black Male Surgical Patients: A Community-Based Participatory Study.The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry · 2026Article
- Association of the cardiovascular-kidney-metabolic syndrome and adverse outcomes after noncardiac surgery.British journal of anaesthesia · 2026Article
- Racial and Ethnic Inequalities Among Survivors of Critical Illness in the MIMIC-IV Database.Journal of intensive care medicine · 2026Article
- Social Determinants of Health and 30-Day Mortality After Inpatient Elective Surgery.JAMA network open · 2026Article
- Article
- Difference in time and risk preferences: physicians and general population across genders.Health economics review · 2025Article
- Race based disparities in clinical and financial outcomes associated with major elective and emergent surgery.Surgery open science · 2025Article
- Semaglutide and Postoperative Outcomes in Nondiabetic Patients Following Body Contouring Surgery.Aesthetic surgery journal · 2025Article
- Observational
- Black-vs-white racial disparities in 30-day outcomes following primary and revisional metabolic and bariatric surgery: a MBSAQIP database analysis.Surgical endoscopy · 2025Observational
- Article
- Measuring hospital inpatient Procedure Access Inequality in the United States.Health affairs scholar · 2024Article
- Care Fragmentation, Social Determinants of Health, and Postoperative Mortality in Older Veterans.The Journal of surgical research · 2024Article
- Modifiable risk factors of inequalities in hypertension: analysis of 100 million health checkups recipients.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess inequities in mortality by race and sex for eight common surgical procedures (elective and non-elective) across specialties in the United States.
designRetrospective cohort study.
settingUS, 2016-18.
participants1 868 036 Black and White Medicare beneficiaries aged 65-99 years undergoing one of eight common surgeries: repair of abdominal aortic aneurysm, appendectomy, cholecystectomy, colectomy, coronary artery bypass surgery, hip replacement, knee replacement, and lung resection.
main outcome measureThe main outcome measure was 30 day mortality, defined as death during hospital admission or within 30 days of the surgical procedure.
resultsPostoperative mortality overall was higher in Black men (1698 deaths, adjusted mortality rate 3.05%, 95% confidence interval 2.85% to 3.24%) compared with White men (21 833 deaths, 2.69%, 2.65% to 2.73%), White women (21 847 deaths, 2.38%, 2.35% to 2.41%), and Black women (1631 deaths, 2.18%, 2.04% to 2.31%), after adjusting for potential confounders. A similar pattern was found for elective surgeries, with Black men showing a higher adjusted mortality (393 deaths, 1.30%, 1.14% to 1.46%) compared with White men (5650 deaths, 0.85%, 0.83% to 0.88%), White women (4615 deaths, 0.82%, 0.80% to 0.84%), and Black women (359 deaths, 0.79%, 0.70% to 0.88%). This 0.45 percentage point difference implies that mortality after elective procedures was 50% higher in Black men compared with White men. For non-elective surgeries, however, mortality did not differ between Black men and White men (1305 deaths, 6.69%, 6.26% to 7.11%; and 16 183 deaths, 7.03%, 6.92% to 7.14%, respectively), although mortality was lower for White women and Black women (17 232 deaths, 6.12%, 6.02% to 6.21%; and 1272 deaths, 5.29%, 4.93% to 5.64%, respectively). These differences in mortality appeared within seven days after surgery and persisted for up to 60 days after surgery.
conclusionsPostoperative mortality overall was higher among Black men compared with White men, White women, and Black women. These findings highlight the need to understand better the unique challenges Black men who require surgery face.
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