Aladine A Elsamadicy, Selma Belkasim, Paul Serrato, Sina Sadeghzadeh, Shaila D Ghanekar, Syed I Khalid, Sheng-Fu Larry Lo, Daniel M Sciubba
{"title":"种族/民族与急性外伤性颈脊髓损伤成人发病率和死亡率的关系。","authors":"Aladine A Elsamadicy, Selma Belkasim, Paul Serrato, Sina Sadeghzadeh, Shaila D Ghanekar, Syed I Khalid, Sheng-Fu Larry Lo, Daniel M Sciubba","doi":"10.1097/BRS.0000000000005260","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>This study aimed to investigate the association of race with morbidity and mortality in acute cervical spinal cord injury (cSCI) patients.</p><p><strong>Summary of background data: </strong>Racial disparities in spine surgery are associated with adverse outcomes, however, the impact of race on cSCI is understudied.</p><p><strong>Methods: </strong>We retrospectively reviewed the American College of Surgeons Trauma Quality Programs database to compare outcomes for acute cSCI patients between racial/ethnic identities: non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic/Latino (HIS), and other (OTH). Demographics, comorbidities, injury type, treatment modality, and adverse events (AEs) were assessed. Multivariable logistic regression was used to identify independent predictors of AEs, non-routine discharge (NRD), and in-hospital mortality.</p><p><strong>Results: </strong>There were 71,048 patients stratified by race/ethnicity: 44,639 (62.8%) NHW, 13,555 (19.1%) NHB, 5,820 (8.2%) HIS, and 7,034 (9.9%) OTH. NHB and HIS-identifying patients had the greatest rates of any AE (NHW: 20.7% vs. NHB: 25.0% vs. HIS: 24.6% vs. OTH: 22.0%, P<0.001) and the longest mean length of stay (NHW: 11.3±13.5 d vs. NHB: 15.5±20.2 d vs. HIS: 15.0±20.5 d vs. OTH: 12.6±17.5 d, P<0.001). NRDs were lowest for HIS-identifying patients (NHW: 74.8% vs. NHB: 75.5% vs. HIS: 69.5% vs. OTH: 75.4%, P<0.001), while in-hospital mortality was lowest for NHB-identifying patients (NHW: 12.8% vs. NHB: 10.1% vs. HIS: 12.4% vs. OTH: 13.4%, P<0.001). On multivariable analyses, NHB (OR: 1.16, P<0.001), HIS (OR: 1.22, P<0.001), and OTH (OR: 1.14, P=0.004) cohorts had significantly increased odds of AEs. The NHB cohort had significantly increased odds (OR: 1.25, P<0.001), while the HIS cohort had significantly decreased odds (OR: 0.78, P=0.001) of NRD. Only the NHB cohort had significantly decreased odds of in-hospital mortality (OR: 0.69, P<0.001).</p><p><strong>Conclusion: </strong>Our study suggests racial disparities in outcomes and discharge disposition for acute cSCI patients.</p>","PeriodicalId":22193,"journal":{"name":"Spine","volume":" ","pages":""},"PeriodicalIF":2.6000,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Racial/Ethnic Associations with Morbidity and Mortality in Adults with Acute Traumatic Cervical Spinal Cord Injury.\",\"authors\":\"Aladine A Elsamadicy, Selma Belkasim, Paul Serrato, Sina Sadeghzadeh, Shaila D Ghanekar, Syed I Khalid, Sheng-Fu Larry Lo, Daniel M Sciubba\",\"doi\":\"10.1097/BRS.0000000000005260\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>This study aimed to investigate the association of race with morbidity and mortality in acute cervical spinal cord injury (cSCI) patients.</p><p><strong>Summary of background data: </strong>Racial disparities in spine surgery are associated with adverse outcomes, however, the impact of race on cSCI is understudied.</p><p><strong>Methods: </strong>We retrospectively reviewed the American College of Surgeons Trauma Quality Programs database to compare outcomes for acute cSCI patients between racial/ethnic identities: non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic/Latino (HIS), and other (OTH). Demographics, comorbidities, injury type, treatment modality, and adverse events (AEs) were assessed. Multivariable logistic regression was used to identify independent predictors of AEs, non-routine discharge (NRD), and in-hospital mortality.</p><p><strong>Results: </strong>There were 71,048 patients stratified by race/ethnicity: 44,639 (62.8%) NHW, 13,555 (19.1%) NHB, 5,820 (8.2%) HIS, and 7,034 (9.9%) OTH. NHB and HIS-identifying patients had the greatest rates of any AE (NHW: 20.7% vs. NHB: 25.0% vs. HIS: 24.6% vs. OTH: 22.0%, P<0.001) and the longest mean length of stay (NHW: 11.3±13.5 d vs. NHB: 15.5±20.2 d vs. HIS: 15.0±20.5 d vs. OTH: 12.6±17.5 d, P<0.001). NRDs were lowest for HIS-identifying patients (NHW: 74.8% vs. NHB: 75.5% vs. HIS: 69.5% vs. OTH: 75.4%, P<0.001), while in-hospital mortality was lowest for NHB-identifying patients (NHW: 12.8% vs. NHB: 10.1% vs. HIS: 12.4% vs. OTH: 13.4%, P<0.001). On multivariable analyses, NHB (OR: 1.16, P<0.001), HIS (OR: 1.22, P<0.001), and OTH (OR: 1.14, P=0.004) cohorts had significantly increased odds of AEs. The NHB cohort had significantly increased odds (OR: 1.25, P<0.001), while the HIS cohort had significantly decreased odds (OR: 0.78, P=0.001) of NRD. Only the NHB cohort had significantly decreased odds of in-hospital mortality (OR: 0.69, P<0.001).</p><p><strong>Conclusion: </strong>Our study suggests racial disparities in outcomes and discharge disposition for acute cSCI patients.</p>\",\"PeriodicalId\":22193,\"journal\":{\"name\":\"Spine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2025-01-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Spine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/BRS.0000000000005260\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/BRS.0000000000005260","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Racial/Ethnic Associations with Morbidity and Mortality in Adults with Acute Traumatic Cervical Spinal Cord Injury.
Study design: Retrospective cohort study.
Objective: This study aimed to investigate the association of race with morbidity and mortality in acute cervical spinal cord injury (cSCI) patients.
Summary of background data: Racial disparities in spine surgery are associated with adverse outcomes, however, the impact of race on cSCI is understudied.
Methods: We retrospectively reviewed the American College of Surgeons Trauma Quality Programs database to compare outcomes for acute cSCI patients between racial/ethnic identities: non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic/Latino (HIS), and other (OTH). Demographics, comorbidities, injury type, treatment modality, and adverse events (AEs) were assessed. Multivariable logistic regression was used to identify independent predictors of AEs, non-routine discharge (NRD), and in-hospital mortality.
Results: There were 71,048 patients stratified by race/ethnicity: 44,639 (62.8%) NHW, 13,555 (19.1%) NHB, 5,820 (8.2%) HIS, and 7,034 (9.9%) OTH. NHB and HIS-identifying patients had the greatest rates of any AE (NHW: 20.7% vs. NHB: 25.0% vs. HIS: 24.6% vs. OTH: 22.0%, P<0.001) and the longest mean length of stay (NHW: 11.3±13.5 d vs. NHB: 15.5±20.2 d vs. HIS: 15.0±20.5 d vs. OTH: 12.6±17.5 d, P<0.001). NRDs were lowest for HIS-identifying patients (NHW: 74.8% vs. NHB: 75.5% vs. HIS: 69.5% vs. OTH: 75.4%, P<0.001), while in-hospital mortality was lowest for NHB-identifying patients (NHW: 12.8% vs. NHB: 10.1% vs. HIS: 12.4% vs. OTH: 13.4%, P<0.001). On multivariable analyses, NHB (OR: 1.16, P<0.001), HIS (OR: 1.22, P<0.001), and OTH (OR: 1.14, P=0.004) cohorts had significantly increased odds of AEs. The NHB cohort had significantly increased odds (OR: 1.25, P<0.001), while the HIS cohort had significantly decreased odds (OR: 0.78, P=0.001) of NRD. Only the NHB cohort had significantly decreased odds of in-hospital mortality (OR: 0.69, P<0.001).
Conclusion: Our study suggests racial disparities in outcomes and discharge disposition for acute cSCI patients.
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Recognized internationally as the leading journal in its field, Spine is an international, peer-reviewed, bi-weekly periodical that considers for publication original articles in the field of Spine. It is the leading subspecialty journal for the treatment of spinal disorders. Only original papers are considered for publication with the understanding that they are contributed solely to Spine. The Journal does not publish articles reporting material that has been reported at length elsewhere.
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