Perelman School of Medicine, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA.
McKenna EpiLog Fellowship in Population Health, University of Pennsylvania, Philadelphia, PA, USA.
J Neurosurg Sci. 2023 Jun;67(3):360-366. doi: 10.23736/S0390-5616.21.05246-2. Epub 2021 Aug 3.
Numerous studies have demonstrated that household income is independently predictive of postsurgical morbidity and mortality, but few studies have elucidated this relationship in a purely spine surgery population. This study aims to correlate household income with adverse events after discectomy for far lateral disc herniation (FLDH).
All adult patients (N.=144) who underwent FLDH surgery at a single, multihospital, 1659-bed university health system (2013-2020) were retrospectively analyzed. Univariate logistic regression was used to evaluate the relationship between household income and adverse postsurgical events, including unplanned hospital readmissions, ED visits, and reoperations.
Mean age of the population was 61.72±11.55 years. Mean household income was $78,283±26,996; 69 (47.9%) were female; and 126 (87.5%) were non-Hispanic white. Ninety-two patients underwent open and fifty-two underwent endoscopic FLDH surgery. Each additional dollar decrease in household income was significantly associated with increased risk of reoperation of any kind within 90-days, but not 30-days, after the index admission. However, household income did not predict risk of readmission or ED visit within either 30-days or 30-90-days postsurgery.
These findings suggest that household income may predict reoperation following FLDH surgery. Additional research is warranted into the relationship between household income and adverse neurosurgical outcomes.
许多研究表明,家庭收入与术后发病率和死亡率独立相关,但很少有研究在单纯的脊柱外科人群中阐明这种关系。本研究旨在探讨家庭收入与极外侧型椎间盘突出症(FLDH)椎间盘切除术后不良事件的关系。
回顾性分析了 2013 年至 2020 年在一家多医院、拥有 1659 张床位的大学健康系统接受 FLDH 手术的所有成年患者(N=144)。采用单变量逻辑回归分析评估家庭收入与术后不良事件(包括计划外住院再入院、急诊就诊和再次手术)之间的关系。
患者的平均年龄为 61.72±11.55 岁。平均家庭收入为 78283±26996 美元;69 例(47.9%)为女性;126 例(87.5%)为非西班牙裔白人。92 例患者接受了开放性手术,52 例患者接受了内镜下 FLDH 手术。家庭收入每减少 1 美元,与索引入院后 90 天内任何类型的再次手术风险增加显著相关,但与 30 天内再次手术风险无关。然而,家庭收入并不能预测术后 30 天或 30-90 天内的再入院或急诊就诊风险。
这些发现表明,家庭收入可能预测 FLDH 手术后的再次手术。需要进一步研究家庭收入与不良神经外科结局之间的关系。