Social Determinants of Health in Endoscopic Anterior Skull Base Surgery: A Systematic Review and Meta-Analysis

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology Pub Date : 2025-10-07 DOI:10.1002/lio2.70264

Shvetali Thatte, Radhika Duggal, Kaelan Wong, Mohamad R. Chaaban

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Abstract

Background

Social determinants of health (SDOH) have been extensively studied in multiple fields, but studies in endoscopic anterior skull base surgery are limited. Our systematic review examines studies analyzing SDOH and their association with endoscopic anterior skull base surgery outcomes.

Methods

This December 2023 systematic review surveyed literature via Embase, Web of Science, MEDLINE, and CENTRAL using predefined syntax analyzing SDOH in endoscopic anterior skull base surgery outcomes. Two independent authors screened the titles, abstracts, and full text for eligibility of inclusion, with a third author resolving any conflicts that arose.

Results

Among 18 studies from 2015 to 2023, the most common SDOH included were insurance status (67%, n = 12), race and ethnicity (61%, n = 11), and SES (50%, n = 9). Common outcomes included rate of postoperative complications (67%, n = 12), length of stay (56%, n = 10), and 30-day readmissions (39%, n = 7). Asian patients had higher odds of 30-day readmission compared to White patients (OR = 1.30, 95% CI: 1.04–1.62, p = 0.02). Black patients had an increased risk of postoperative diabetes insipidus compared to White patients (RR = 1.32, 95% CI: 1.09–1.59, p < 0.01). Medicaid patients had higher odds for 30-day readmission (OR = 1.30, 95% CI: 1.08–1.56, p < 0.01) and greater risk of postoperative diabetes insipidus (RR = 1.25, 95% CI: 1.02–1.52, p = 0.03) compared to private insurance patients.

Conclusions

Several studies indicate that race and insurance status significantly influence rates for readmission and postoperative complications in endoscopic anterior skull base surgery. The heterogeneity of other SDOH suggests further research to consolidate the findings and explore potential links explaining the observed variations.

Level of Evidence

Abstract Image

查看原文本刊更多论文

内窥镜前颅底手术中健康的社会决定因素：系统回顾和荟萃分析。

背景：健康的社会决定因素（SDOH）已经在多个领域进行了广泛的研究，但内窥镜前颅底手术的研究有限。我们系统回顾了分析SDOH及其与内窥镜前颅底手术结果的关系的研究。方法：本系统综述于2023年12月通过Embase、Web of Science、MEDLINE和CENTRAL检索文献，使用预定义语法分析SDOH在内镜下前颅底手术结果中的影响。两位独立作者筛选标题、摘要和全文以确定是否符合纳入条件，第三位作者解决出现的任何冲突。结果：在2015 - 2023年的18项研究中，最常见的SDOH包括保险状况（67%,n = 12）、种族和民族（61%,n = 11）和经济地位（50%,n = 9）。常见结局包括术后并发症发生率（67%,n = 12）、住院时间（56%,n = 10）和30天再入院（39%,n = 7）。与白人患者相比，亚裔患者30天再入院的几率更高（OR = 1.30, 95% CI: 1.04-1.62, p = 0.02）。黑人患者术后尿崩症的风险比白人患者高（RR = 1.32, 95% CI: 1.09-1.59, p p p = 0.03）。结论：几项研究表明，种族和保险状况显著影响内镜前颅底手术的再入院率和术后并发症。其他SDOH的异质性建议进一步研究以巩固研究结果并探索解释观察到的变化的潜在联系。证据等级：3。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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