Journal article
Low Socioeconomic Status Is Associated With Increased Complication Rates: Are Risk Adjustment Models Necessary in Cervical Spine Surgery?
Global spine journal, v 10(6), pp 748-753
Sep 2020
PMID: 32707010
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Study Design:
Retrospective cohort study.
Objectives:
The objective of this study was to determine whether lower socioeconomic status was associated with increased resource utilization following anterior discectomy and fusion (ACDF).
Methods:
The National Inpatient Sample database was queried for patients who underwent a primary, 1- to 2-level ACDF between 2005 and 2014. Trauma, malignancy, infection, and revision surgery were excluded. The top and bottom income quartiles were compared. Demographics, medical comorbidities, length of stay, complications, and hospital cost were compared between patients of top and bottom income quartiles.
Results:
A total of 69 844 cases were included. The bottom income quartile had a similar mean hospital stay (2.04 vs 1.77 days, P = .412), more complications (2.45% vs 1.77%, P < .001), and a higher mortality rate (0.18% vs 0.11%, P = .016). Multivariate analysis revealed bottom income quartile was an independent risk factor for complications (odds ratio = 1.135, confidence interval = 1.02-1.26). Interestingly, the bottom income quartile experienced lower mean hospital costs ($17 041 vs $17 958, P < .001).
Conclusion:
Patients in the lowest income group experienced more complications even after adjusting for comorbidities. Therefore, risk adjustment models, including socioeconomic status, may be necessary to avoid potential problems with access to orthopedic spine care for this patient population.
Metrics
Details
- Title
- Low Socioeconomic Status Is Associated With Increased Complication Rates: Are Risk Adjustment Models Necessary in Cervical Spine Surgery?
- Creators
- Alexander M. Lieber - Drexel UniversityAnthony J. Boniello - Drexel UniversityYehuda E. Kerbel - Drexel UniversityPhilip Petrucelli - Drexel UniversityVenkat Kavuri - Drexel UniversityAndre Jakoi - Orthopedic Health of Kansas City, North Kansas City, MO, USA.Amrit S. Khalsa - Hospital of the University of Pennsylvania
- Publication Details
- Global spine journal, v 10(6), pp 748-753
- Publisher
- Sage
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000490938800001
- Scopus ID
- 2-s2.0-85088445555
- Other Identifier
- 991019330632304721
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InCites Highlights
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Clinical Neurology
- Orthopedics