Summary
Summary: Authors assess inequities in mortality by race and sex for eight common surgical procedures (elective and nonelective) across specialties in the United States. The study consisted of 1,868,036 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. The main outcome measure was 30-day mortality, defined as death during hospital admission or within 30 days of the surgical procedure.
Findings: Postoperative mortality overall was higher in Black men compared with white men, white women, and Black women, after adjusting for potential confounders. A similar pattern was found for elective surgeries, with Black men showing a higher adjusted mortality compared with white men, white women, and Black women. This 0.45 percentage point difference implies that mortality after elective procedures was 50% higher in Black men compared with white men.
For nonelective surgeries, however, mortality did not differ between Black men and white men, although mortality was lower for white women and Black women. These differences in mortality appeared within seven days after surgery and persisted for up to 60 days after surgery. Postoperative 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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