Association Between Median Household Income and Perioperative Outcomes of Lumbar Spinal Fusion: An Analysis of the National Inpatient Sample (2009-2020).

Autor: Khan AMA; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA., Quiceno E; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA., Soliman MAR; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA; Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt., Elbayomy AM; Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA., Malueg MD; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA., Aguirre AO; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA., Greisman JD; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA., Kuo CC; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA., Whelan TJ; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA., Im J; Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA., Levy HW; The George Washington University School of Medicine and Health Sciences, Seattle, Washington, USA., Nichol REM 3rd; Williams College, Williamstown, Massachusetts, USA., Khan A; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA., Pollina J; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA., Mullin JP; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA. Electronic address: jmullin@ubns.com.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Oct 15. Date of Electronic Publication: 2024 Oct 15.
DOI: 10.1016/j.wneu.2024.09.096
Abstrakt: Background: Relationships between low socioeconomic status and surgical outcomes are well established for certain procedures. However, scant literature has focused on relationships between median household income and lumbar fusion outcomes.
Methods: Patients who underwent fusion procedures between January 1, 2009 and December 31, 2020 were identified from the National Inpatient Sample database. They were categorized into 4 quartiles, from lowest to highest, based on median household incomes in respective zip codes. We applied univariable and multivariable linear and logistic regression models to analyze perioperative data according to income quartiles.
Results: We included 2,826,396 patients. In multivariable regression, patients in the 3 lowest income quartiles exhibited higher rates of in-hospital cardiac events perioperatively, with odds ratios (ORs) of 1.19 (95% confidence interval [CI]1.13-1.26, P < 0.001), 1.10 (95% CI 1.05-1.16, P < 0.001), and 1.06 (95% CI 1.01-1.12, P = 0.011) for the first, second, and third quartiles, respectively. Patients in the lowest income (first) quartile had a higher occurrence of perioperative urinary complications (OR = 1.07, 95% CI 1.03-1.12, P = 0.001), systemic infectious complications (OR = 1.17, 95% CI 1.04-1.32, P = 0.006), neurological deficit (OR = 1.17, 95% CI 1.06-1.30, P = 0.002), and wound infections (OR = 1.22, 95% CI 1.12-1.34, P < 0.001). Those in the 3 lowest income quartiles were less likely to experience respiratory, gastrointestinal, and venous thrombotic complications (P < 0.05). The lowest income quartile had protective associations for dural tears (OR 0.93, 95% CI 0.89-0.99, P = 0.038) and postprocedure anemia across all 3 lower quartiles, with OR < 1 and P < 0.001.
Conclusions: Reduced household income significantly affected perioperative outcomes after lumbar fusion and should be taken into consideration during the perioperative period.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: