Harvard Medical School, Boston, Massachusetts; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
World Neurosurg. 2021 Nov;155:e484-e502. doi: 10.1016/j.wneu.2021.08.087. Epub 2021 Aug 27.
Despite research indicating that patients with non-English primary language (NEPL) have increased hospital length of stay (LOS) for craniotomies, there is a paucity of neurosurgical research examining the impact of language on short-term outcomes. This study sought to evaluate short-term outcomes for patients with English primary language (EPL) and NEPL admitted for resection of a supratentorial tumor.
Using the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project New Jersey State Inpatient Database, this study included patients 18-90 years old who underwent resection of a supratentorial primary brain tumor, meningioma, or brain metastasis from 2009 to 2017. The primary outcomes were total, preoperative, and postoperative LOS. Secondary outcomes were complications, mortality, and discharge disposition. Univariable and multivariable analyses compared Spanish primary language (SPL), non-English non-Spanish (NENS) primary language, and EPL groups.
A total of 7324 patients were included: 2962 with primary brain tumor, 2091 with meningioma, and 2271 with brain metastasis. Patients with SPL (n = 297) were younger and more likely to have noncommercial insurance, lower income, and fewer comorbidities. Patients with NENS (n = 257) had similar age and comorbidities to the EPL group but had a greater proportion of noncommercially insured and low-income patients (P < 0.001). Multivariable analysis showed that patients with NENS had increased postoperative LOS (adjusted incidence rate ratio, 1.10; P = 0.008) and higher odds of a complication (adjusted odds ratio, 1.36; P = 0.015), and patients with SPL had higher odds of being discharged home (adjusted odds ratio, 1.55; P = 0.017).
Patients with NEPL have different short-term outcomes after supratentorial tumor resection that varies based on primary language. More research is needed to understand the mechanisms driving these findings and to clarify unique experiences for different populations with NEPL.
尽管有研究表明，母语非英语的患者在接受开颅手术后的住院时间（LOS）会延长，但神经外科领域缺乏关于语言对短期预后影响的研究。本研究旨在评估母语为英语（EPL）和非英语母语（NEPL）的患者接受幕上肿瘤切除术的短期预后。
本研究使用美国医疗保健研究与质量医疗保健成本和利用项目新泽西州住院患者数据库，纳入 2009 年至 2017 年间接受幕上原发性脑肿瘤、脑膜瘤或脑转移切除术的 18-90 岁患者。主要结局指标为总 LOS、术前 LOS 和术后 LOS。次要结局指标为并发症、死亡率和出院去向。采用单变量和多变量分析比较西班牙语（SPL）、非英语非西班牙语（NENS）和 EPL 组。
共纳入 7324 例患者：原发性脑肿瘤 2962 例，脑膜瘤 2091 例，脑转移瘤 2271 例。SPL 组（n=297）患者年龄较小，更有可能拥有非商业保险、收入较低且合并症较少。NENS 组（n=257）患者的年龄和合并症与 EPL 组相似，但非商业保险和低收入患者的比例更大（P<0.001）。多变量分析显示，NENS 组患者术后 LOS 延长（校正发病率比，1.10；P=0.008）和并发症发生率较高（校正优势比，1.36；P=0.015），SPL 组患者更有可能被送回家（校正优势比，1.55；P=0.017）。
幕上肿瘤切除术后，母语为 NEPL 的患者的短期预后不同，具体情况因主要语言而异。需要进一步研究以了解导致这些发现的机制，并阐明不同 NEPL 人群的独特经历。
