Racial and ethnic disparities in the incidence and mortality from septic shock and respiratory failure among elective neurosurgery patients
| Autor: | Doniel Drazin, Magda Shaheen, Alexander O. Firempong, Deyu Pan |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Databases Factual Logistic regression California Neurosurgical Procedures Young Adult Internal medicine Case fatality rate medicine Odds Ratio Humans Young adult Aged business.industry Septic shock Incidence (epidemiology) Incidence Age Factors General Medicine Odds ratio Middle Aged medicine.disease Shock Septic Surgery Neurology Respiratory failure Elective Surgical Procedures Female Neurology (clinical) business Elective Surgical Procedure Respiratory Insufficiency |
| Zdroj: | Neurological research. 36(10) |
| ISSN: | 1743-1328 |
| Popis: | Septic shock (SS) and respiratory failure (RF) are serious complications after neurosurgical procedures. Research is limited in studying racial/ethnic disparities in incidence and mortality of SS and RF. The study aimed to determine the racial variation in incidence and mortality from SS and RF among elective neurosurgical patients in California.Data were analyzed from 206 902 admissions of elective neurosurgical patients in California from 2001 to 2009. Variables included race/ethnicity, age, gender, insurance, procedure site, and co-morbidities. We used descriptive, bivariate, and multivariate statistics in SAS v9·3.Septic shock incidence was 0·30/1000/year and case fatality (CF) was 47·7%. Respiratory failure incidence was 4·7/1000/year and CF was 26·2%. Blacks had higher SS and RF (0·6 and 7·9%, respectively) compared to Whites (0·2 and 4·3%, respectively) (Chi-square, P0·01). In the adjusted logistic regression model, Blacks had higher odds of SS (Adjusted Odds Ratio [AOR] = 1·56, 95% CI = 1·16-2·10) and RF (AOR = 1·22, 95% CI = 1·11-1·33) relative to Whites. Although, Blacks had higher mortality from SS (58·9%) and RF (30·1%) compared to Whites (45·2 and 26·4%, respectively; P0·05), the AORs were not statistically significant (P0·05).Blacks had a higher incidence of SS and RF. A higher percentage of black patients died from SS-related mortality, followed by Hispanics, than other groups. The attenuation of differences after statistical adjustment suggests the excess mortality may be due to age, site of the procedures, and having neoplastic disease. Our findings support the need for prospective studies to assess specific pre-operative interventions driven by age and co-morbidities that might reduce the risk of complications after neurosurgical procedures. |
| Databáze: | OpenAIRE |
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