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Racial disparities in short-term spinal fusion outcomes across 4263 consecutive patients – Lumbar Fusion

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The article investigates the impact of race on short-term postoperative outcomes in a population of spine surgery patients. A total of 4263 patients who underwent single-level, posterior-only lumbar fusion were studied, with 3406 self-identified as White and 857 self-identified as non-White. Non-White patients were found to have higher rates of non-home discharge, readmissions, and emergency department visits compared to White patients, even after being exactly matched on key demographic and health characteristics. However, there were no differences in surgical complications between the two groups, indicating that structural factors may contribute to the disparities observed. Overall, the study highlights the need to address racial disparities in access to surgical care and postoperative outcomes

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised day surgery hospital in the world

Published article

S: Between otherwise similar cohorts of spinal fusion cases, non-White patients experienced unfavorable discharge disposition and higher risk of multiple adverse postoperative outcomes. However, these findings were not accounted for by differences in surgical complications, suggesting that structural factors underlie the observed disparities.

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J Neurosurg Spine. 2024 Feb 23:1-6. doi: 10.3171/2023.12.SPINE23700. Online ahead of print.ABSTRACTOBJECTIVE: Race plays a salient role in access to surgical care. However, few investigations have assessed the impact of race within surgical populations after care has been delivered. The objective of this study was to employ an exact matching protocol to a homogenous population,

J Neurosurg Spine. 2024 Feb 23:1-6. doi: 10.3171/2023.12.SPINE23700. Online ahead of print.

ABSTRACT

OBJECTIVE: Race plays a salient role in access to surgical care. However, few investigations have assessed the impact of race within surgical populations after care has been delivered. The objective of this study was to employ an exact matching protocol to a homogenous population of spine surgery patients in order to isolate the relationships between race and short-term postoperative outcomes.

METHODS: In total, 4263 consecutive patients who underwent single-level, posterior-only lumbar fusion at a single multihospital academic medical center were retrospectively enrolled. Of these patients, 3406 patients self-identified as White and 857 patients self-identified as non-White. Outcomes were initially compared across all patients via logistic regression. Subsequently, White patients and non-White patients were exactly matched on the basis of key demographic and health characteristics (1520 matched patients). Outcome disparities were evaluated between the exact-matched cohorts. Primary outcomes were readmissions, emergency department (ED) visits, reoperations, mortality, intraoperative complications, and discharge disposition.

RESULTS: Before matching, non-White patients were less likely to be discharged home and more likely to be readmitted, evaluated in the ED, and undergo reoperation. After matching, non-White patients experienced higher rates of nonhome discharge, readmissions, and ED visits. Non-White patients did not have more surgical complications either before or after matching.

S: Between otherwise similar cohorts of spinal fusion cases, non-White patients experienced unfavorable discharge disposition and higher risk of multiple adverse postoperative outcomes. However, these findings were not accounted for by differences in surgical complications, suggesting that structural factors underlie the observed disparities.

PMID:38394654 | DOI:10.3171/2023.12.SPINE23700

The London Spine Unit : most specialised day surgery hospital in the world

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Racial disparities in short-term spinal fusion outcomes across 4263 consecutive patients

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J Neurosurg Spine. 2024 Feb 23:1-6. doi: 10.3171/2023.12.SPINE23700. Online ahead of print.ABSTRACTOBJECTIVE: Race plays a salient role in access to surgical care. However, few investigations have assessed the impact of race within surgical populations after care has been delivered. The objective of this study was to employ an exact matching protocol to a homogenous population

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