Table 1.
Included study descriptions and summary of findings
| First author, year | Study design; cohort years | Age group; participants* (n) | Surgical discipline; procedure(s) | M&M postoperative outcome category | Overall difference in M&M for IN | Overall quality assessment |
|---|---|---|---|---|---|---|
| North America | ||||||
| Canada | ||||||
| Beres 2010 [18] | Retrospective cohort; 2006–2008 | Pediatric (< 21); total n = 210; Northern Aboriginal n = 68; local n = 142 | Pediatric general surgery; appendectomy | Surgical site infections (wound infection/abscess); other morbidity: (perforation, ileus); postoperative readmission; LOS differences | No difference | Poor |
| Matsuda-Abedini 2009 [19] | Retrospective cohort; 1985–2005 | Pediatric (< 18); total n = 159; Aboriginal n = 24; non-Aboriginal n = 135 | Pediatric urology; renal transplantation | Immunologic complications (delayed-graft function, acute rejection, late rejection, eGFR at 5 years); > 30-day mortality (all-cause mortality) | Increased | Poor |
| Samuel 2011 [20] | Retrospective cross-sectional cohort; 1992–2007 | Pediatric (< 22); total n = 291; Aboriginal n = 35; White n = 256 | Pediatric urology; renal transplantation | Immunologic complications (first graft failure within 1-year) | Increased | Poor |
| USA | ||||||
| Attenello 2015 [21] | Retrospective cross-sectional; 2000, 2003, 2006, 2009 | Pediatric (< 21); total n = 16,941; Native American n = 155; white n = 16,786 | Pediatric neurosurgery; ventriculoatrial shunt, ventriculopleural shunt, ventriculoperitoneal shunt, replacement of ventricular shunt | 30-day mortality (30-day mortality, inpatient death); non-routine discharge | Increased | Good |
| Sherrod 2016 [22] | Retrospective cross-sectional cohort; 2012–2013 | Pediatric (< 18); total n = 7228; Native American n = 57; Pacific Islander n = 24; White n = 7204 | Pediatric neurosurgery; myelomeningocele repairs, spine procedures, craniectomy/craniotomy, shunt/ventricular catheter including revision/removal, skin lesions, other | Postoperative readmission (unplanned readmission) | Increased | Poor |
| Stone 2013 [23] | Retrospective cross-sectional; 2003, 2006 | Pediatric (< 21); total n = 59,185; Native American n = 474; White n = 58,711 | Pediatric general surgery; appendectomy, pyloromyotomy, intussusception, decortication, congenital diaphragmatic hernia repair, colonic resection for Hirschsprung's disease | 30-day mortality (postoperative); Overall Morbidity (postoperative morbidity (wound (mechanical), infection, urinary, pulmonary, gastrointestinal, cardiovascular, systemic, and procedural); LOS | No difference | Good |
| Zwintscher, 2014 [24] | Retrospective cross-sectional cohort; 2009 | Pediatrics (< 20); total n = 45,043; Native American n = 828; Caucasian n = 44,215 | Pediatric general surgery; appendectomy | Surgical site infections (wound, dehiscence, gangrene; hematologic complications (anemia, hemorrhage, hematoma); pulmonary complications (pneumonia, other respiratory); postoperative reoperation (including for incisional hernias and postoperative obstruction) other postoperative complications (foreign body, UTI, shock) | No difference | Poor |
| Oceania | ||||||
| Australia | ||||||
| Chinnaratha 2014 [25] | Retrospective cross-sectional cohort; 1985–2012 | Pediatric (< 16): total = 638; indigenous (Aboriginal Australian and Torres Strait Islander) n = 14; non-indigenous n = 622 | Pediatric general surgery; liver transplantation | Overall morbidity: (1, 3, 5, 10, 15-year graft survival) > 30 day mortality: (1, 3, 5, 10, 15-year overall survival) | No difference | Poor |
| Jassar 2009 [26] | Retrospective cohort; 1996–2004 | Pediatric (< 10); total n = 213; indigenous n = 111; non-indigenous n = 102 | Pediatric ENT; tympanostomy | Surgical site infections (postoperative infection) | No difference | Poor |
| Justo 2017 [27] | Retrospective cohort; 2008–2014 | Pediatric; total n = 1528; indigenous (Aboriginal Australian and Torres Strait Islander) n = 123; non-indigenous n = 1405 | Pediatric cardiac surgery; CHD surgery | 30-day mortality (30-day mortality, surgical survival 5 year unadjusted); LOS differences (ICU stay (days), hospital stay (days), surgical re-intervention) | Increased | Good |
| New Zealand | ||||||
| Campbell 2016 [28] | Retrospective cohort; 2004–2013 | Pediatric (< 15); total n = 153; Māori n = 34; European n = 119 | Pediatric general surgery; cholecystectomy | Overall morbidity: operative complications (bile leak, bowel injury, bowel obstruction, cholangitis, wound infection, hemorrhage, cardiorespiratory, pseudocyst) | Increased | Poor |
| Chong 2021 [29] | Retrospective cross-sectional cohort; 2005–2014 | Pediatrics (< 20); total n = 3414; Māori n = 698; PI n = 219; European n = 3195 | Pediatric ophthalmology; strabismus repairs | Postoperative reoperation (reoperation rates for surgical failures) | Increased | Poor |
| Cloete 2019 [30] | Retrospective cohort; 2006–2014 | Pediatric (< 18); total n = 144; Māori n = 38; PI n = 13; European n = 113 | Pediatric cardiac surgery; HLHS, Aortic coarctation, interrupted aortic arch, aortic valve/supravalvular anomalies repairs | 30-day mortality (postoperative mortality) | Increased | Poor |
| Johnston 2018 [31] | Retrospective cross-sectional cohort; 1996–2006 | Pediatric (< 10); total n = 11,941; Māori n = 2387; non-Māori n = 9554 | Pediatric ENT; Myringotomy + tube insertion | Postoperative Readmission (30-day readmission rate with surgical complication); postoperative reoperation; LOS differences. total number of readmissions for surgery | No difference | Poor |
CHD congenital heart disease, eGFR estimated glomerular filtration rate, ENT ears, nose, throat, HLHS hypoplastic left heart syndrome, ICU intensive care unit, IN indigenous, LOS length of (hospital) stay, M&M mortality and morbidity, PI Pacific Islander
*Participant populations are listed as reported in individual studies