TY - JOUR
T1 - Complications and mortality in cervical spine surgery
T2 - Racial differences
AU - Skolasky, Richard L.
AU - Thorpe, Roland J.
AU - Wegener, Stephen T.
AU - Riley, Lee H.
PY - 2014/8/15
Y1 - 2014/8/15
N2 - 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.
AB - 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.
KW - anterior cervical spine surgery
KW - complications
KW - disparity
KW - mortality
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U2 - 10.1097/BRS.0000000000000429
DO - 10.1097/BRS.0000000000000429
M3 - Article
C2 - 24859586
AN - SCOPUS:84906322754
SN - 0362-2436
VL - 39
SP - 1506
EP - 1512
JO - Spine
JF - Spine
IS - 18
ER -