Journal of Clinical Neuroscience最新文献

{"title":"Comparison of 30-day surgical outcomes of multi-level sub-axial anterior (ACDF) vs posterior (PCDF) approach to cervical decompression and fusion in the setting of pre-operative malnutrition","authors":"Taylor Furst,&nbsp;Aman Singh,&nbsp;Prasanth Romiyo,&nbsp;Jonathan Stone,&nbsp;Tyler Schmidt","doi":"10.1016/j.jocn.2025.111358","DOIUrl":"10.1016/j.jocn.2025.111358","url":null,"abstract":"<div><div>Evidence continues to mount supporting the detrimental effects malnutrition has on spine surgery outcomes. However, improving nutrition with cervical pathology faces challenges, such as progressive neurological decline with surgical delays, which may force intervention despite patient malnutrition. The American College of Surgeons National Surgical Quality Improvement Project (NSQIP) database was queried to identify adult patients who underwent multi-level sub-axial anterior cervical discectomy and fusion (ACDF) or posterior cervical decompression and fusion (PCDF) from 2015 to 2022 in the setting of pre-operative malnutrition defined by hypoalbuminemia. Univariate and multivariate analyses were performed. In univariate analysis, PCDF had significantly higher rates of post-operative complications (32.3 % vs 20.4 %, p &lt; 0.001), non-home discharges (71.3 % vs 43.7 %, p &lt; 0.001), superficial surgical site infections (1.4 % vs 0.0 %, p = 0.007), urinary tract infections (5.9 % vs 2.9 %, p = 0.02) and blood transfusions (12.8 % vs 5.3 %, p &lt; 0.001) as well as longer LOS (7.9 ± 6.2 vs 5.1 ± 5.8 days, p &lt; 0.0005) compared to ACDF. When controlling for confounding variables, including levels of instrumentation and baseline characteristics, via multivariate analysis, all significance was lost. 30-day readmissions, RTOR and 30-day mortality did not differ between groups. Overall, short term surgical outcomes of ACDF vs PCDF in adult patients with malnutrition are similar. Surgical approach should be guided by surgeon judgement and be tailored to individual patient needs. Data on long term outcomes within this population is needed.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111358"},"PeriodicalIF":1.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes and consequences of ‘delays’ in the diagnosis of spinal dural arterio-venous fistula; An illustrative case series, review and commentary","authors":"Danielle Chéné ,&nbsp;Simon Clark ,&nbsp;Derek Yull ,&nbsp;Josh Yee ,&nbsp;Yun-Hom Yau ,&nbsp;Ian R. Whittle","doi":"10.1016/j.jocn.2025.111346","DOIUrl":"10.1016/j.jocn.2025.111346","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111346"},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excessive daytime sleepiness may predict early post-stroke cognitive impairment in elderly with non-disabling ischemic stroke","authors":"ZhenHui Lu ,&nbsp;XiaoMing Guo ,&nbsp;Can Xing ,&nbsp;LianHai Zhu ,&nbsp;JinYu Gu ,&nbsp;XiangYang Zhu","doi":"10.1016/j.jocn.2025.111359","DOIUrl":"10.1016/j.jocn.2025.111359","url":null,"abstract":"<div><h3>Background</h3><div>Daytime sleepiness is common in the acute phase of cerebral ischemic stroke and affects the clinical outcome, but whether it is associated with post-stroke cognitive function remains unclear.</div></div><div><h3>Objective</h3><div>To define the relationship between daytime sleepiness and early cognitive impairment after non-disabling ischemic stroke in elderly.</div></div><div><h3>Methods</h3><div>This prospective study included consecutive elderly patients with acute non-disabling ischemic stroke (aged &gt; 60 years; NIHSS score ≤ 3 at admission; onset-to-enrollment time ≤ 7 days). Excessive daytime sleepiness (EDS) was diagnosed based on the Epworth Sleepiness Scale (ESS). Cognition was assessed by the Montreal cognitive assessment (MoCA) at admission and at 3-, 12-month follow-ups. Cognitive impairment was defined as MoCA score &lt; 26 (≥12 years education) or &lt; 25 (&lt;12 years education). According to MoCA score at 3-month, patients were divided into two groups: Early post-stroke cognitive impairment (PSCI) group, and Non-PSCI group. Intergroup comparisons were performed for general demographic data, laboratory information, imaging data, ESS scores, and MoCA scores, followed with further correlation analysis between ESS scores and early PSCI.</div></div><div><h3>Results</h3><div>Of the 243 enrolled patients (mean age, 68.7 ± 6.6 years; female, 35.4 %), 160 (65.8 %) developed early PSCI. The two groups of patients were significantly different in ESS score during the acute phase, history of hypertension, coronary heart disease, atrial fibrillation, C-reactive protein, TOAST type, Fazekas scale of leukoaraiosis, MTA score of hippocampal volume. After adjustment for potential confounding variables, ESS score during the acute phase was positively associated with early PSCI (adjusted odds ratio 1.146, 95 % confidence interval 1.040–1.262, <em>P</em> = 0.006). According to receiver operating characteristic analysis, the best projecting factor for early PSCI was an ESS score ≥ 7 (area under the curve 0.593; sensitivity 48.1 %; specificity 69.9 %). Besides early PSCI, EDS during the acute phase was also associated with a higher risk of stroke recurrence and poor outcomes.</div></div><div><h3>Conclusion</h3><div>The occurrence of early PSCI in elderly patients with non-disabling ischemic stroke was related to EDS during the acute phase. Attention to ESS score during the acute phase is needed in these elderly patients for early diagnosis and timely intervention of PSCI.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111359"},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI for disease prediction: Performance insights and key limitations","authors":"Yiquan Wang ,&nbsp;Minnuo Cai ,&nbsp;Tin-Yeh Huang","doi":"10.1016/j.jocn.2025.111360","DOIUrl":"10.1016/j.jocn.2025.111360","url":null,"abstract":"","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111360"},"PeriodicalIF":1.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intensive versus non-intensive statin therapy in patients with ischemic stroke: A systematic review and meta-analysis","authors":"Felipe Moraes Costa ,&nbsp;Kaike Lobo ,&nbsp;João Lucas Lalor Tavares ,&nbsp;Ruan Pablo da Silva Gomes ,&nbsp;Leonardo Santos ,&nbsp;Rita de Cássia Silva de Oliveira","doi":"10.1016/j.jocn.2025.111361","DOIUrl":"10.1016/j.jocn.2025.111361","url":null,"abstract":"<div><h3>Background</h3><div>Intensive and non-intensive statin therapies are commonly used to manage ischemic stroke, a major cause of death and disability worldwide. However, the ideal statin therapy intensity in the acute phase remains uncertain. This study evaluates whether intensive statin therapy leads to better functional and clinical outcomes than non-intensive therapy in patients with ischemic stroke.</div></div><div><h3>Methods</h3><div>A comprehensive search of four databases was conducted from inception through January 2025. Eligible studies included randomized controlled trials (RCTs) or observational studies comparing intensive versus non-intensive statin therapy in acute ischemic stroke patients. Meta-analysis was conducted using a random-effects model in Review Manager.</div></div><div><h3>Results</h3><div>11 studies involving 53.118 patients met the inclusion criteria. Intensive statin therapy significantly improved good functional outcomes based on the modified Rankin scale (mRS 0–2) at three months (78.1 % vs. 75.1 %; OR 1.12; 95 % CI 1.05, 1.19; p = 0.0008; I² = 0 %) and favorable functional outcomes (mRS 0–3) (87.1 % vs. 85.0 %; OR 1.14; 95 % CI 1.05, 1.23; p = 0.001; I² = 0 %). However, intensive therapy was associated with a higher risk of intracerebral hemorrhage (0.8 % vs. 0.5 %; OR 1.60; 95 % CI 1.01, 2.54; p = 0.05; I² = 53 %). No significant differences were observed between groups regarding stroke recurrence, bleeding events, acute coronary syndrome and all-cause mortality.</div></div><div><h3>Conclusion</h3><div>Intensive statin therapy improves functional recovery at three months in ischemic stroke patients but does not significantly affect stroke recurrence, bleeding events, or mortality. However, it is associated with an increased risk of ICH.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111361"},"PeriodicalIF":1.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144194958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paediatric ventriculoperitoneal shunt obstruction and cerebrospinal fluid protein","authors":"Charles F. Yates ,&nbsp;Michael J. Colditz ,&nbsp;Liam Maclachlan ,&nbsp;Martin J. Wood ,&nbsp;Norman Ma ,&nbsp;Amelia Jardim ,&nbsp;Raymond Chaseling ,&nbsp;Robert Campbell","doi":"10.1016/j.jocn.2025.111341","DOIUrl":"10.1016/j.jocn.2025.111341","url":null,"abstract":"<div><h3>Background</h3><div>Ventriculoperitoneal shunt (VPS) insertion is a life-saving intervention for hydrocephalus. Device failure is extremely common, and carries immense morbidity for patients, their families, and the healthcare system. Predicting shunt obstruction remains a substantial challenge. Clinically, cerebrospinal fluid protein (CSFp) is suspected to contribute to VPS obstruction, this is widely debated, and definitive evidence is lacking. We assess the relationship of CSFp in predicting VPS failure in children.</div></div><div><h3>Methods</h3><div>A retrospective review of VPS procedures at the Queensland Children’s Hospital between 2014–2019 was conducted. The relationship between CSFp level and outcome were explored. A conventional CSFp threshold above 500 mg/L is considered elevated, however a continuous relationship was assessed to better describe concentration associations. Outcome variables were early (&lt;90-days) and late VPS obstruction (&lt;1-year). A CNS infection was reason for exclusion. A logarithmic correction was applied to CSFp (Log-CSFp) for statistical modelling.</div></div><div><h3>Results</h3><div>552 procedures were assessed in 243 patients. Fifty-eight (10.5 %) VP shunts obstructed within 90-days, 87 (15.8 %) within 1-year. 63 patients (25.9 %) experienced an episode of &lt;1-year VPS obstruction. Multivariate analysis found Log-CSFp was predictive for early VPS obstruction (OR 1.40, 1.20–1.63, p &lt; 0.0001), and late VPS obstruction (OR 1.37, 1.17–1.62, p &lt; 0.0001) independent to hydrocephalus aetiology, patient age, and CSF red blood cell count. Older patient age was a significant protective factor for late VPS obstruction (OR 0.89, 0.82–0.96, p = 0.002).</div></div><div><h3>Conclusions</h3><div>CSFp holds prognostic value for VPS obstruction in paediatric patients, a relentlessly unpredictable complication of VPS devices, informing procedure timing, patient follow-up and risk-stratification.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"137 ","pages":"Article 111341"},"PeriodicalIF":1.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral health as a modifiable risk factor for neurodegeneration: Prudent optimism and interdisciplinary action","authors":"Edmond El Choueiri ,&nbsp;Jad El Choueiri ,&nbsp;Amine El Choueiri","doi":"10.1016/j.jocn.2025.111354","DOIUrl":"10.1016/j.jocn.2025.111354","url":null,"abstract":"<div><div>Neurodegenerative diseases, including Alzheimer’s disease (AD) and Parkinson’s disease (PD), represent a growing public health burden, necessitating exploration of modifiable risk factors. Emerging evidence suggests a link between poor oral health, particularly chronic periodontitis, and neurodegeneration, mediated by systemic inflammation, direct bacterial invasion, and disruptions in the microbiota-gut-brain axis. Periodontal pathogens, such as Porphyromonas gingivalis, have been suggested to contribute to neuroinflammation, blood–brain barrier dysfunction, and amyloid-beta aggregation, all of which are implicated in AD pathology. Additionally, tooth loss and masticatory dysfunction could further exacerbate cognitive decline through reduced cerebral stimulation and impaired nutrient absorption. While the association between periodontitis and neurodegeneration is compelling, causality remains uncertain, warranting further longitudinal and interventional studies. Interdisciplinary collaboration between neurologists and dental professionals is essential to establish oral health as a potential preventive strategy for neurodegenerative diseases. Routine periodontal screenings, improved oral hygiene awareness, and early intervention could help mitigate cognitive decline. Moreover, salivary biomarkers show promise as non-invasive tools for early detection of neurodegeneration. Addressing socioeconomic and healthcare disparities in access to both dental and neurological care is crucial in minimizing disease burden. Future research should focus on mechanistic studies and randomized trials to determine whether and how periodontal interventions can influence neurodegenerative disease progression.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"138 ","pages":"Article 111354"},"PeriodicalIF":1.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144178134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for preoperative anxiety and depression in patients with unruptured intracranial aneurysms scheduled for endovascular embolization","authors":"Zhuo Yang ,&nbsp;Lang Zeng ,&nbsp;Hua Li ,&nbsp;Rudong Chen ,&nbsp;Jian Ma ,&nbsp;Xiaoli Min ,&nbsp;Jiasheng Yu","doi":"10.1016/j.jocn.2025.111343","DOIUrl":"10.1016/j.jocn.2025.111343","url":null,"abstract":"<div><h3>Objective</h3><div>In managing patients with unruptured intracranial aneurysms (UIAs), neurosurgeons primarily focus on assessing rupture risk and selecting appropriate treatment strategies. However, limited attention has been given to patients’ preoperative psychological status and the prevalence of mental health disorders. This study aims to investigate the levels of preoperative anxiety and depression in patients scheduled for endovascular embolization for UIAs and identify potential risk factors contributing to these conditions.</div></div><div><h3>Methods</h3><div>A total of 121 patients diagnosed with UIAs and scheduled for embolization between January 2021 and June 2023 were enrolled. Preoperative evaluations were conducted using the Hospital Anxiety and Depression Scale (HADS), with demographic and clinical data, as well as anxiety and depression scores, systematically recorded. Chi-square tests and t-tests were used for univariate analyses, and logistic regression models were constructed to identify independent risk factors associated with preoperative anxiety and depression.</div></div><div><h3>Results</h3><div>Among the 121 participants, 42 (34.7 %) demonstrated borderline or clinical anxiety, while 40 (33.1 %) exhibited borderline or clinical depression. Logistic regression analysis identified age (OR: 0.945, 95 % CI: 0.906–0.986, <em>P</em> = 0.008), type of interventional therapy (OR: 2.706, 95 % CI: 1.124–6.516, <em>P</em> = 0.026), and preoperative clinical symptoms (OR: 4.188, 95 % CI: 1.780–9.852, <em>P</em> = 0.001) as independent risk factors for significant abnormalities in HADS-Anxiety (HADS-A). For preoperative depression, higher body mass index (BMI) (OR: 1.256, 95 % CI: 1.042–1.515, <em>P</em> = 0.017), preoperative clinical symptoms (OR: 3.597, 95 % CI: 1.532–8.444, <em>P</em> = 0.003), and ASA grade (OR: 1.897, 95 % CI: 1.113–3.233, <em>P</em> = 0.019) were identified as independent predictors of abnormal HADS- Depression (HADS-D) scores.</div></div><div><h3>Conclusions</h3><div>A substantial proportion of patients with UIAs scheduled for endovascular treatment exhibit preoperative anxiety and depression. Independent risk factors for preoperative anxiety include age, type of interventional therapy, and preoperative symptoms. For depression, preoperative symptoms, BMI, and ASA grade are key contributors. These findings underscore the importance of targeted psychological assessment and support in this patient population.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"137 ","pages":"Article 111343"},"PeriodicalIF":1.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel association of the Rotterdam computed tomography score with decompressive craniectomy in acute traumatic subdural hematoma","authors":"Tianqi Xiao ,&nbsp;Asha Sethuraman ,&nbsp;Mohamed E. El-Abtah ,&nbsp;John J. Francis ,&nbsp;Deven Reddy ,&nbsp;Mary Jo Roach ,&nbsp;Michael L. Kelly","doi":"10.1016/j.jocn.2025.111350","DOIUrl":"10.1016/j.jocn.2025.111350","url":null,"abstract":"<div><h3>Background and Objectives</h3><div>The decision to perform a craniotomy (CO) versus decompressive craniectomy (DC) for acute subdural hematomas (aSDH) after traumatic brain injury (TBI) remains challenging. Rotterdam Computed Tomography (RCT) scoring has been shown to correlate with outcome measures in TBI. This study examines the association between RCT scoring and the decision to pursue CO or DC in TBI patients with aSDH.</div></div><div><h3>Methods</h3><div>A single-center retrospective review was conducted on adult patients who presented with aSDH and received either a CO or DC between 2018 and 2021. Baseline demographics and clinical presentation characteristics were collected. Chi-square, Wilcoxon sum rank test, and <em>t</em>-test were used to compare means. Multivariate stepwise logistic regression models were developed for a predictive model and the receiver operating characteristic curve was analyzed.</div></div><div><h3>Results</h3><div>A total of 126 patients were identified. Patients who underwent DC compared to CO had significantly younger age, higher Injury Severity Scores (ISS), lower Glasgow Come Scale (GCS), and higher RCT scores. After multivariate stepwise logistic regression, GCS and RCT scores greater than or equal to 3 (RCT3) were independently associated with DC in aSDH. Patients with RCT3 were three times more likely to undergo DC (odds ratio 3.22; 95% confidence interval: 1.19–8.67).</div></div><div><h3>Conclusion</h3><div>A RCT score of greater than or equal to 3, a younger age, and lower GCS were associated with increased odds of undergoing DC compared to CO for traumatic aSDHs. RCT scores are associated with DC versus CO in patients with aSDH.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"137 ","pages":"Article 111350"},"PeriodicalIF":1.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced sociodemographic disparities in surgical outcomes after spine surgery for spinal epidural abscess","authors":"Aladine A. Elsamadicy ,&nbsp;Shaila D. Ghanekar ,&nbsp;Paul Serrato ,&nbsp;Lucas P. Mitre ,&nbsp;Luis Kolb ,&nbsp;Sheng-fu Larry Lo ,&nbsp;Daniel M. Sciubba","doi":"10.1016/j.jocn.2025.111351","DOIUrl":"10.1016/j.jocn.2025.111351","url":null,"abstract":"<div><h3>Background</h3><div>Investigation into the effect of demographic identifiers, such as race and socioeconomic status, on health outcomes has risen to the forefront of research across medical disciplines attempting to understand the complex interplay of factors that lead to health disparities. This study aims to identify racial disparities in outcomes following spine surgery for spinal epidural abscess (SEA).</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the 2011–2022 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database to identify adult patients who underwent spinal surgery for spinal epidural abscess. The study population was stratified by race and ethnicity into four groups: non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic (HIS), and Other (OTH). Multivariable logistic regression analyses were performed to identify factors associated with extended length of stay (LOS), adverse events (AEs), non-routine discharge (NRD), 30-day unplanned reoperation, and mortality.</div></div><div><h3>Results</h3><div>Of the 1,654 adult patients, 1198 (72.4 %) identified as NHW, 184 (11.1 %) identified as NHB, 188 (11.4 %) identified as HIS, and 84 (5.1 %) identified as OTH. The NHB cohort had the highest proportion of individuals with mFI-5 scores <u>&gt;</u> 2 (NHW: 26.9 % <em>vs</em>. NHB: 39.1 % <em>vs</em>. Hispanic: 27.7 % <em>vs</em>. Other: 34.5 %, p = 0.002). No significant difference in rates of 30-day AEs, LOS, operation time, NRD, 30-day reoperation, or mortality were noted between the groups. On both univariate (OR: 1.80, CI: 1.10–2.93, p = 0.019) and multivariate (aOR: 2.48, CI: 1.41–4.38, p = 0.002) analysis, the OTH cohort was associated with a significantly higher risk of extended hospitalization. There were no other significant associations between cohort and risk for AEs, NRD, 30-day reoperation, or mortality.</div></div><div><h3>Conclusion</h3><div>Our study suggests that there are reduced racial disparities in post-surgical outcomes for SEA patients. Additionally, the comorbidity burden seems to be associated with worsening outcomes. Further studies are necessary to corroborate our findings.</div></div>","PeriodicalId":15487,"journal":{"name":"Journal of Clinical Neuroscience","volume":"137 ","pages":"Article 111351"},"PeriodicalIF":1.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144168699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}