Racial Disparities in Elderly Patients Receiving Lumbar Spinal Stenosis Surgery

Global Spine Journal
Doniel DrazinMaxwell Boakye

Abstract

Retrospective cohort study. To evaluate for racial disparities in elderly patients having undergone lumbar spinal stenosis surgery. The US Medicare Provider Analysis and Review database (records from 2005 to 2011) was used to identify patients over the age of 65 years, diagnosed with lumbar spinal stenosis, and having undergone lumbar laminectomy or fusion surgery. Blacks were compared to Whites in both unmatched and propensity score-matched populations. The data was analyzed with univariate (χ(2) and Wilcoxon rank sum tests for unmatched comparison, and McNemar exact and signed rank sum tests for matched comparison) and multivariate models. Query of the data resulted in a study sample of 12 807 patients; 514 (4.0%) were identified as Black and 12 293 (96%) as White. Blacks were less likely to be discharged home (42.4% vs 58.9%, P < .0001) and had lower repeat operation rates (6.81% vs 11.5%, P = .0009); both remained significant in the propensity score-matched comparison. Finally, Blacks experienced more postoperative complications, higher median Medicare costs, but lower out-of-pocket expenses (P = .0113). Blacks had higher rates of diabetes (33.7% vs 21.5%, P < .0001) and obesity (9.92% vs 6.85%, P = .0074), when compared to...Continue Reading

References

Jan 7, 2011·Journal of Clinical Epidemiology·Joshua J GagneSebastian Schneeweiss
Aug 16, 2011·Circulation. Arrhythmia and Electrophysiology·Florian RaderEugene H Blackstone
Dec 13, 2012·Spine·Shivanand P LadMaxwell Boakye
Sep 11, 2013·The Spine Journal : Official Journal of the North American Spine Society·Chi Heon KimByung Joo Park
Oct 10, 2013·Obstetrics and Gynecology·Elizabeth A HowellNina Bickell
Dec 3, 2013·The Spine Journal : Official Journal of the North American Spine Society·Chirag G PatilMaxwell Boakye

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Citations

Sep 5, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Nirav K PandyaDerek Ward
Jun 24, 2017·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Tridu R HuynhDoniel Drazin
Aug 27, 2019·Global Spine Journal·Zachary SanfordChad Patton
Jan 15, 2021·The Journal of the American Academy of Orthopaedic Surgeons·Jennifer J BeckMary K Mulcahey
Aug 15, 2021·World Neurosurgery·Jaimin PatelDaniel M Sciubba
Oct 12, 2021·World Neurosurgery·Imad S KhanTimothy C Ryken
Oct 25, 2021·World Neurosurgery·Tyler CardinalGabriel Zada

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

SAS

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