Hispanic Patients Undergoing Spinal Fusion for Neuromuscular Scoliosis Sustain Health Inequalities
Introduction: Pre- and postoperative optimization remains a complex process impacted by various demographic factors. Our study aims to identify and describe those demographic factors associated with poor outcomes after spinal fusion with instrumentation in neuromuscular scoliosis to reduce health di...
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| Format: | Article |
| Language: | English |
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The Japanese Society for Spine Surgery and Related Research
2025-01-01
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| Series: | Spine Surgery and Related Research |
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| Online Access: | https://www.jstage.jst.go.jp/article/ssrr/9/1/9_2023-0271/_pdf/-char/en |
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| author | Armando S. Martinez David Momtaz Travis Kotzur Alexandra McLennan Abdullah Ghali Farhan Ahmad Ebubechi Adindu Alan C. Santiago-Rodriquez Ali Seifi Brian Smith |
| author_facet | Armando S. Martinez David Momtaz Travis Kotzur Alexandra McLennan Abdullah Ghali Farhan Ahmad Ebubechi Adindu Alan C. Santiago-Rodriquez Ali Seifi Brian Smith |
| author_sort | Armando S. Martinez |
| collection | DOAJ |
| description | Introduction: Pre- and postoperative optimization remains a complex process impacted by various demographic factors. Our study aims to identify and describe those demographic factors associated with poor outcomes after spinal fusion with instrumentation in neuromuscular scoliosis to reduce health disparities and improve postoperative outcomes.
Methods: A retrospective analysis was conducted using Healthcare Cost and Utilization Project data from 2016 to 2020, encompassing a random sample of 20% of procedures in the United States. Data included demographic and hospital variables, including days from admission to the procedure, length of stay, recovery time, total charge, discharge disposition, and mortality rates. In addition to ANOVA, Chi-Squares, and t-tests, multiple-linear and multiple-logistic regression models were designed and run to generate adjusted odds ratios.
Results: Compared to non-Hispanic patients (N=1829), Hispanic patients (N=431) had spinal fusion with instrumentation at younger ages (12.9 vs. 14.1 years old, p=0.011) and had significantly different household incomes with less representation in the 75th to 100th percentile (16.8% vs. 26.5%, p<0.001). Additionally, Hispanic patients were more likely to be Medicaid users (67.2% vs. 46.0%, p<0.001). Hispanic patients undergoing spinal fusion with instrumentation had longer lengths of stay (LOS) (10.0 vs. 7.6 days, p<0.001), longer periods from admission to surgery (wait time) (1.6 vs. 1.0 days, p=0.046), and longer recovery times (8.5 vs. 6.7 days, p<0.001).
Conclusions: Hispanic patients with NMS often have longer lengths of stay, longer periods between admission and surgery, and longer recovery times than non-Hispanic patients. This difference in hospital courses and surgical timing could be an effect of disparities in healthcare access and socioeconomic standing. Further efforts are required to both understand and reduce barriers to healthcare access in the Hispanic patient population undergoing spinal fusion with instrumentation. |
| format | Article |
| id | doaj-art-19aa797e5b3444c9936de26fdd07c659 |
| institution | Kabale University |
| issn | 2432-261X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The Japanese Society for Spine Surgery and Related Research |
| record_format | Article |
| series | Spine Surgery and Related Research |
| spelling | doaj-art-19aa797e5b3444c9936de26fdd07c6592025-02-09T23:30:07ZengThe Japanese Society for Spine Surgery and Related ResearchSpine Surgery and Related Research2432-261X2025-01-0191364410.22603/ssrr.2023-02712023-0271Hispanic Patients Undergoing Spinal Fusion for Neuromuscular Scoliosis Sustain Health InequalitiesArmando S. Martinez0David Momtaz1Travis Kotzur2Alexandra McLennan3Abdullah Ghali4Farhan Ahmad5Ebubechi Adindu6Alan C. Santiago-Rodriquez7Ali Seifi8Brian Smith9Department of Orthopaedics, Texas Children's Hospital, Houston, Baylor College of MedicineDepartment of Neurosurgery, UT Health San AntonioDepartment of Neurosurgery, UT Health San AntonioDepartment of Orthopaedics, Texas Children's Hospital, Houston, Baylor College of MedicineDepartment of Orthopaedics, Texas Children's Hospital, Houston, Baylor College of MedicineDepartment of Orthopaedics, Rush Medical CenterDepartment of Orthopaedics, Texas Children's Hospital, Houston, Baylor College of MedicineDepartment of Orthopaedics, Texas Children's Hospital, Houston, Baylor College of MedicineDepartment of Neurosurgery, UT Health San AntonioDepartment of Orthopaedics, Texas Children's Hospital, Houston, Baylor College of MedicineIntroduction: Pre- and postoperative optimization remains a complex process impacted by various demographic factors. Our study aims to identify and describe those demographic factors associated with poor outcomes after spinal fusion with instrumentation in neuromuscular scoliosis to reduce health disparities and improve postoperative outcomes. Methods: A retrospective analysis was conducted using Healthcare Cost and Utilization Project data from 2016 to 2020, encompassing a random sample of 20% of procedures in the United States. Data included demographic and hospital variables, including days from admission to the procedure, length of stay, recovery time, total charge, discharge disposition, and mortality rates. In addition to ANOVA, Chi-Squares, and t-tests, multiple-linear and multiple-logistic regression models were designed and run to generate adjusted odds ratios. Results: Compared to non-Hispanic patients (N=1829), Hispanic patients (N=431) had spinal fusion with instrumentation at younger ages (12.9 vs. 14.1 years old, p=0.011) and had significantly different household incomes with less representation in the 75th to 100th percentile (16.8% vs. 26.5%, p<0.001). Additionally, Hispanic patients were more likely to be Medicaid users (67.2% vs. 46.0%, p<0.001). Hispanic patients undergoing spinal fusion with instrumentation had longer lengths of stay (LOS) (10.0 vs. 7.6 days, p<0.001), longer periods from admission to surgery (wait time) (1.6 vs. 1.0 days, p=0.046), and longer recovery times (8.5 vs. 6.7 days, p<0.001). Conclusions: Hispanic patients with NMS often have longer lengths of stay, longer periods between admission and surgery, and longer recovery times than non-Hispanic patients. This difference in hospital courses and surgical timing could be an effect of disparities in healthcare access and socioeconomic standing. Further efforts are required to both understand and reduce barriers to healthcare access in the Hispanic patient population undergoing spinal fusion with instrumentation.https://www.jstage.jst.go.jp/article/ssrr/9/1/9_2023-0271/_pdf/-char/enscoliosisneuromuscularneuromuscular scoliosisdemographichispanichealthinequalitiesspinal fusioninstrumentation |
| spellingShingle | Armando S. Martinez David Momtaz Travis Kotzur Alexandra McLennan Abdullah Ghali Farhan Ahmad Ebubechi Adindu Alan C. Santiago-Rodriquez Ali Seifi Brian Smith Hispanic Patients Undergoing Spinal Fusion for Neuromuscular Scoliosis Sustain Health Inequalities Spine Surgery and Related Research scoliosis neuromuscular neuromuscular scoliosis demographic hispanic health inequalities spinal fusion instrumentation |
| title | Hispanic Patients Undergoing Spinal Fusion for Neuromuscular Scoliosis Sustain Health Inequalities |
| title_full | Hispanic Patients Undergoing Spinal Fusion for Neuromuscular Scoliosis Sustain Health Inequalities |
| title_fullStr | Hispanic Patients Undergoing Spinal Fusion for Neuromuscular Scoliosis Sustain Health Inequalities |
| title_full_unstemmed | Hispanic Patients Undergoing Spinal Fusion for Neuromuscular Scoliosis Sustain Health Inequalities |
| title_short | Hispanic Patients Undergoing Spinal Fusion for Neuromuscular Scoliosis Sustain Health Inequalities |
| title_sort | hispanic patients undergoing spinal fusion for neuromuscular scoliosis sustain health inequalities |
| topic | scoliosis neuromuscular neuromuscular scoliosis demographic hispanic health inequalities spinal fusion instrumentation |
| url | https://www.jstage.jst.go.jp/article/ssrr/9/1/9_2023-0271/_pdf/-char/en |
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