Complications and Mortality in Cervical Spine Surgery Racial Differences

被引:46
作者
Skolasky, Richard L. [1 ]
Thorpe, Roland J., Jr. [2 ,3 ]
Wegener, Stephen T. [4 ]
Riley, Lee H., III [1 ]
机构
[1] Johns Hopkins Univ, Dept Orthopaed Surg, Baltimore, MD 21224 USA
[2] Johns Hopkins Univ, Dept Hlth Behav Soc, Baltimore, MD 21224 USA
[3] Johns Hopkins Univ, Hopkins Ctr Hlth Dispar Solut, Baltimore, MD 21224 USA
[4] Johns Hopkins Univ, Dept Phys Med & Rehabil, Baltimore, MD 21224 USA
关键词
anterior cervical spine surgery; mortality; complications; disparity; HIGH-VOLUME HOSPITALS; RESEARCH TRIAL SPORT; KNEE ARTHROPLASTY; UNITED-STATES; HIP-ARTHROPLASTY; LUMBAR SPINE; DISPARITIES; RACE; RATES; OUTCOMES;
D O I
10.1097/BRS.0000000000000429
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Study Design. Retrospective national database analysis. Objective. Our goal was to estimate racial and ethnic differences in in-hospital complication and mortality rates associated with cervical spine surgery. Summary of Background Data. The impact of observed racial and ethnic disparities in orthopedic spine care use on morbidity and mortality is not well understood. Methods. On the basis of the Nationwide Inpatient Sample, there were 983,420 adult nontrauma hospital discharges from 2000 through 2009. In-hospital complications and mortality were the outcome variables. The primary independent variable was race/ ethnicity (defined as non-Hispanic white [white], non-Hispanic black [black], and Hispanic). Covariates were age, sex, household income, insurance status, geographical location, hospital volume, and comorbidities. Multivariable regression models were used to determine the association between race/ethnicity and in-hospital complication and mortality. Significance was set at a P value less than 0.05. Results. The overall rates of an in-hospital complication or mortality were 4.09% and 0.42%, respectively. There were no differences in the rates of in-hospital complications or mortality between Hispanics and Caucasians. Compared with Caucasians, African Americans had higher odds of experiencing an in-hospital complication (odds ratio, 1.37; 95% confidence interval, 1.27-1.48) and higher odds of dying during hospitalization (odds ratio, 1.59; 95% confidence interval, 1.30-1.96). Conclusion. Although there were no differences between Caucasians and Hispanics, African Americans had significantly higher rates of in-hospital complications and mortality associated with cervical spine surgery than did Caucasians. These differences persisted after adjusting for known risk factors for complications and mortality.
引用
收藏
页码:1506 / 1512
页数:7
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