Open AccessRacial Disparities in Perioperative Morbidity Following Oncological Spine Surgery
Author(s) -
Rafael De la Garza Ramos,
Jong Hyun Choi,
Ishan Naidu,
Joshua Benton,
Murray Echt,
Vijay Yanamadala,
Peter G. Passias,
John H. Shin,
David Altschul,
C. Rory Goodwin,
Daniel M. Sciubba,
Reza Yassari
Publication year - 2021
Publication title -
global spine journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.398
H-Index - 26
eISSN - 2192-5690
pISSN - 2192-5682
DOI - 10.1177/21925682211022290
Subject(s) - medicine , perioperative , surgery , odds ratio , retrospective cohort study , cohort , complication
Study Design: Retrospective cohort study.Objective: To assess the impact of race on complications following spinal tumor surgery.Methods: Adults with cancer who underwent spine tumor surgery were identified in the American College of Surgeons National Surgical Quality Improvement Program datasets from 2012 to 2016. Clavien-Dindo Grade I-II (minor complications) and Clavien-Dindo Grade III-V (major complications including 30-day mortality) complications were compared between non-Hispanic Whites (NHW) and Black patients. A multivariable analysis was also conducted.Results: Of 1,226 identified patients, 85.9% were NHW (n = 1,053) and 14.1% were Black (n = 173). The overall rate of Grade I-II complications was 16.2%; 15.1% for NHW patients and 23.1% for Black patients ( P = .008). On multivariable analysis, Black patients had significantly higher odds of having a minor complication (OR 1.87; 95% CI, 1.16-3.01; P = .010). On the other hand, the overall rate of Grade III-V complications was 13.3%; 12.5% for NHW patients and 16.2% for Black patients ( P = .187). On multivariable analysis, Black race was not independently associated with major complications (OR 1.26; 95% CI, 0.71-2.23; P = .430). Median length of stay was 8 days (IQR 5-13) for NHW patients and 10 days (IQR 6-15) for Black patients ( P = .011).Conclusion: Black patients who underwent metastatic spinal tumor surgery were at a significantly increased risk of perioperative morbidity compared to NHW patients independent of baseline and operative characteristics. Major complications did not differ between groups. Race should be further studied in the context of metastatic spine disease to improve our understanding of these disparities.