Do racial disparities exist in a spine surgery practice that serves a predominately minority population? Outcomes of transforaminal lumbar interbody fusion: A retrospective review

Background: Racial minority status is associated with inferior peri-operative outcomes following spinal fusion. Findings have largely been reported within institutions serving few minority patients. This study aimed to identify if racial disparities exist for transforaminal lumbar interbody fusion (...

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Main Authors: Harrison A. Volaski, Zachary T. Sharfman, Priyam Shah, Ananth Eleswarapu, David S. Geller, Jonathan Krystal
Format: Article
Language:English
Published: Elsevier 2022-12-01
Series:North American Spine Society Journal
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666548422000749
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author Harrison A. Volaski
Zachary T. Sharfman
Priyam Shah
Ananth Eleswarapu
David S. Geller
Jonathan Krystal
author_facet Harrison A. Volaski
Zachary T. Sharfman
Priyam Shah
Ananth Eleswarapu
David S. Geller
Jonathan Krystal
author_sort Harrison A. Volaski
collection DOAJ
description Background: Racial minority status is associated with inferior peri-operative outcomes following spinal fusion. Findings have largely been reported within institutions serving few minority patients. This study aimed to identify if racial disparities exist for transforaminal lumbar interbody fusion (TLIF) procedures within an urban academic medical center which serves a majority non-White population. Methods: This is a retrospective review of patients who underwent a TLIF procedure at our institution between 06/2016-10/2019. Primary outcome measures included length of stay (LOS), discharge disposition, 30-day return to the emergency department (ED), 30-day readmission rate, and 30-day complication rates. One-hundred-fifty-six patients (female: male, 99: 57) met inclusion criteria. Demographic and clinical data (body mass index (BMI), comorbidities, preoperative lab values) were compared. Results: The mean LOS was 6.2, 5.9, and 6 days in the White, Hispanic, and Black cohorts, respectively (p = 0.92). There were no differences in discharge disposition between groups (p = 0.52). Thirty-day post-operative complication rates did not differ between groups (p > 0.07). Readmission rates did not differ between groups (p > 0.05). ED visits were more prevalent in the Hispanic group with 16 visits as compared to 8 and 4 in the White and Black groups respectively (p = 0.01). Conclusions: We found no racial disparities in terms of LOS, discharge disposition, or 30-day readmission rates. Hispanic patients demonstrated an increased utilization of the ED in the early post-operative period. Efforts to overcome language barriers, communicate instructions clearly, and outline post-operative expectations and plans may prevent the need for post-operative ED visits.
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spelling doaj.art-477aa0afc0c84eb6a0ed55cfed2dd7282022-12-22T04:41:59ZengElsevierNorth American Spine Society Journal2666-54842022-12-0112100171Do racial disparities exist in a spine surgery practice that serves a predominately minority population? Outcomes of transforaminal lumbar interbody fusion: A retrospective reviewHarrison A. Volaski0Zachary T. Sharfman1Priyam Shah2Ananth Eleswarapu3David S. Geller4Jonathan Krystal5Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, NY, USA; Corresponding author at: 111 E 210th St., Bronx, NY 10467.Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USADepartment of Orthopaedic Surgery, Montefiore Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USADepartment of Orthopaedic Surgery, Montefiore Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USADepartment of Orthopaedic Surgery, Montefiore Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USADepartment of Orthopaedic Surgery, Montefiore Medical Center, Bronx, NY, USA; Albert Einstein College of Medicine, Bronx, NY, USABackground: Racial minority status is associated with inferior peri-operative outcomes following spinal fusion. Findings have largely been reported within institutions serving few minority patients. This study aimed to identify if racial disparities exist for transforaminal lumbar interbody fusion (TLIF) procedures within an urban academic medical center which serves a majority non-White population. Methods: This is a retrospective review of patients who underwent a TLIF procedure at our institution between 06/2016-10/2019. Primary outcome measures included length of stay (LOS), discharge disposition, 30-day return to the emergency department (ED), 30-day readmission rate, and 30-day complication rates. One-hundred-fifty-six patients (female: male, 99: 57) met inclusion criteria. Demographic and clinical data (body mass index (BMI), comorbidities, preoperative lab values) were compared. Results: The mean LOS was 6.2, 5.9, and 6 days in the White, Hispanic, and Black cohorts, respectively (p = 0.92). There were no differences in discharge disposition between groups (p = 0.52). Thirty-day post-operative complication rates did not differ between groups (p > 0.07). Readmission rates did not differ between groups (p > 0.05). ED visits were more prevalent in the Hispanic group with 16 visits as compared to 8 and 4 in the White and Black groups respectively (p = 0.01). Conclusions: We found no racial disparities in terms of LOS, discharge disposition, or 30-day readmission rates. Hispanic patients demonstrated an increased utilization of the ED in the early post-operative period. Efforts to overcome language barriers, communicate instructions clearly, and outline post-operative expectations and plans may prevent the need for post-operative ED visits.http://www.sciencedirect.com/science/article/pii/S2666548422000749Minimally invasivelumbarspinal fusionoutcomescomplicationsracial disparity
spellingShingle Harrison A. Volaski
Zachary T. Sharfman
Priyam Shah
Ananth Eleswarapu
David S. Geller
Jonathan Krystal
Do racial disparities exist in a spine surgery practice that serves a predominately minority population? Outcomes of transforaminal lumbar interbody fusion: A retrospective review
North American Spine Society Journal
Minimally invasive
lumbar
spinal fusion
outcomes
complications
racial disparity
title Do racial disparities exist in a spine surgery practice that serves a predominately minority population? Outcomes of transforaminal lumbar interbody fusion: A retrospective review
title_full Do racial disparities exist in a spine surgery practice that serves a predominately minority population? Outcomes of transforaminal lumbar interbody fusion: A retrospective review
title_fullStr Do racial disparities exist in a spine surgery practice that serves a predominately minority population? Outcomes of transforaminal lumbar interbody fusion: A retrospective review
title_full_unstemmed Do racial disparities exist in a spine surgery practice that serves a predominately minority population? Outcomes of transforaminal lumbar interbody fusion: A retrospective review
title_short Do racial disparities exist in a spine surgery practice that serves a predominately minority population? Outcomes of transforaminal lumbar interbody fusion: A retrospective review
title_sort do racial disparities exist in a spine surgery practice that serves a predominately minority population outcomes of transforaminal lumbar interbody fusion a retrospective review
topic Minimally invasive
lumbar
spinal fusion
outcomes
complications
racial disparity
url http://www.sciencedirect.com/science/article/pii/S2666548422000749
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