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Impact of social factors on outcomes following pediatric neuro-oncology surgery in the United States: a systematic review and meta-analysis
Journal article   Peer reviewed

Impact of social factors on outcomes following pediatric neuro-oncology surgery in the United States: a systematic review and meta-analysis

Neerav Kumar, Grace Dydian Xu, Cooper Lathrop, Jeffrey Shi, Abhinav Kumar, Graham Winston, Danyal Ahmed Quraishi, Izzet Akosman, Alexandra Giantini Larsen, Ibrahim Hussain, …
Neurosurgical review, v 48(1), 334
28 Mar 2025
DOI: https://doi.org/10.1007/s10143-025-03477-2
PMID: 40148684
Featured in Collection :   UN Sustainable Development Goals @ Drexel

Abstract

Brain Neoplasms - surgery Child Female Humans Neurosurgical Procedures Postoperative Complications - epidemiology Social Factors Socioeconomic Factors Treatment Outcome United States
To use AI-assisted software to identify gender, racial, and socioeconomic differences in post-operative outcomes following pediatric neuro-oncology surgery. PubMed, Scopus, Web of Science, and Ovid were queried using a semi-automated software. Meta-analyses quantified pooled odds ratios for overall survival (OS), gross total resection (GTR), recurrence, 30-day readmission, medical complications (neurologic and endocrinologic), and surgical complications. Where possible, subanalyses were performed based on study type and cranial tumor location. Sixty-seven studies were included. Across all studies, white children had greater OS (OR 0.70, 95% CI [0.55, 0.88]) and GTR (OR 0.86, 95% CI [0.78, 0.93]), while non-white children more often had a medical complication (OR 1.33, 95% CI [1.01, 1.76]). Those with government insurance (OR 1.72, 95% CI [1.01, 2.92]) or lower household income (OR 1.25, 95% CI [1.10, 1.42]) had higher 30-day readmission rates. Patients treated at a small-volume facility had lower rates (OR 0.80, 95% CI [0.71, 0.91]). Subanalyses of case series showed female patients were at higher risk of endocrinologic complications (OR 2.56, 95% CI [1.17, 5.64]), namely hypopituitarism (OR 3.29, 95% CI [1.10, 9.86]). In cohort studies, female patients more often experienced diabetes insipidus (OR 2.22, 95% CI [1.20, 4.08]). Non-white, government-insured, lower-income, and female patients are more likely to experience an adverse event. This study identifies the importance of considering demographic variables during pre-operative risk assessment. Our findings warrant further subgroup analyses across varying tumor locations and types to elucidate parameters contributing to these disparities and explore interventions.

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Surgery
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