Racial Disparities in Plastic Surgery Outcomes: A Systematic Literature Review and Meta-Analysis.

Abstract

Racial disparities in surgical outcomes have been shown to lead to subpar results in various patients. Variability and contradictions in the current literature highlight the need for a crucial evaluation of the matter in studies focusing on plastic and reconstructive surgery. Investigating the matter is a pivotal step toward effective guidelines that mitigate factors contributing to racial disparities in outcomes and improve our perception of a patient-centered health-care system. The study aimed to identify whether racial disparities exist in plastic and reconstructive surgery procedures. Systematic review of the literature as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was performed to find relevant articles assessing the impact of race on surgical outcomes. PubMed, Embase, MEDLINE, and Cochrane library were screened by both authors, and relevant articles were identified. Prevalence of complications were extracted from included studies, and odds ratio (OR) with 95% confidence interval (CI) was calculated and grouped for a statistical analysis. Meta-analysis of 13 studies, with a mean of 8059 patients per study, demonstrated a pooled OR of 1.21 (95% CI: 1.00-1.46), indicating an insignificant association between non-White race and postoperative complications. Subanalysis comparing African American patients to White patients (10 studies) showed an OR of 1.36 (95% CI: 1.06-1.74), signifying a statistically significant risk for African Americans. No publication bias was observed, but substantial heterogeneity (73% and 79%) suggested varied study factors influencing outcomes. Racial disparities exist in plastic and reconstructive outcomes. Physicians and medical staff should focus on patients' sociodemographic background, accessibility to care, support cycles, and language proficiency, while determining the surgical plan and postoperative care.