The Impact of Household Economics on Short-Term Outcomes in a Posterior Fossa Tumor Population.
brain tumor
outcome disparities
posterior fossa
readmissions
socioeconomics
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
02 Jul 2020
02 Jul 2020
Historique:
entrez:
9
8
2020
pubmed:
9
8
2020
medline:
9
8
2020
Statut:
epublish
Résumé
Background Disparities exist in medical care and may result in avoidable negative clinical care outcomes for those affected. There remains a paucity in the literature regarding the impact of economic disparities on neurosurgical outcomes. Methods A total of 283 consecutive posterior fossa brain tumor resections, excluding cerebellopontine angle tumors, over a six-year period (June 07, 2013, to April 29, 2019) at a single, multihospital academic medical center were analyzed retrospectively. Outcomes evaluated included 30-day readmission and mortality, emergency department (ED) evaluation, unplanned return to surgery within 30 days, and return to surgery after index admission within 30 days. The population was divided into quartiles based on median household income, and univariate analysis was conducted between the lowest (Q1) and highest (Q4) socioeconomic quartiles, with significance set at a p < 0.05. Stepwise regression was conducted to determine the correlations among study variables and identify confounding factors. Results Whole population univariate analysis demonstrated lower socioeconomic status (SES) to be correlated with increased mortality within 30 post-operative days and increased return to surgery after index admission. No significant difference was found with regard to 30-day readmission, ED evaluation, unplanned reoperation, or return to surgery after index admission. Decreasing, but not significant, mortality was demonstrated between Q1 and Q4 socioeconomic quartiles. Conclusions This study suggests that low SES, when defined by household income, correlates with increased mortality within 30 days and an increased need for return to surgery within 30 days. There may be an opportunity for hospitals and care providers to use SES to proactively identify high-risk patients and test the impact of supports in the post-operative setting.
Identifiants
pubmed: 32766010
doi: 10.7759/cureus.8968
pmc: PMC7398728
doi:
Types de publication
Journal Article
Langues
eng
Pagination
e8968Informations de copyright
Copyright © 2020, Blue et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Am Coll Surg. 2008 Sep;207(3):312-9
pubmed: 18722934
J Thorac Cardiovasc Surg. 2012 Jun;143(6):1314-23
pubmed: 22341420
J Epidemiol Community Health. 2008 Oct;62(10):882-9
pubmed: 18791046
Anesthesiology. 2011 Apr;114(4):837-46
pubmed: 21372682
Med Care. 2008 Sep;46(9):893-9
pubmed: 18725842
Surg Neurol. 2009 Oct;72(4):369-75
pubmed: 19604553
J Natl Med Assoc. 2002 Aug;94(8):666-8
pubmed: 12152921
World Neurosurg. 2011 Feb;75(2):279-85
pubmed: 21492731
JAMA Surg. 2015 Feb;150(2):110-7
pubmed: 25472485
J Neurosurg Pediatr. 2015 Jun;15(6):560-6
pubmed: 25791773
Epilepsy Behav. 2016 Feb;55:133-8
pubmed: 26773684
J Health Care Poor Underserved. 2010 Aug;21(3):913-30
pubmed: 20693735
Neurosurgery. 2010 Mar;66(3):427-37; discussion 437-8
pubmed: 20124933
BJOG. 2016 Jan;123(2):300-8
pubmed: 26331299
Global Spine J. 2020 May;10(3):252-260
pubmed: 32313789
Head Neck. 2015 May;37(5):685-93
pubmed: 24596299
PLoS One. 2018 Jan 22;13(1):e0191464
pubmed: 29357383
Ann Surg. 2010 Sep;252(3):552-7; discussion 557-8
pubmed: 20739856
J Bone Joint Surg Am. 2016 Aug 17;98(16):1385-91
pubmed: 27535441
J Clin Oncol. 2009 Aug 20;27(24):3945-50
pubmed: 19470926
Health Serv Res. 2018 Jun;53(3):1407-1429
pubmed: 28480588
Spine (Phila Pa 1976). 2017 Feb;42(3):195-201
pubmed: 28125441
J Chronic Dis. 1987;40(5):373-83
pubmed: 3558716
Lancet. 2008 Nov 8;372(9650):1661-9
pubmed: 18994664
Arch Surg. 2010 Mar;145(3):247-53
pubmed: 20231625
J Am Coll Surg. 2013 Mar;216(3):482-92.e12
pubmed: 23318117
J Neurosurg Pediatr. 2013 Sep;12(3):235-40
pubmed: 23829377