Huang Vincent, Miranda Stephen P, Dimentberg Ryan, Shultz Kaitlyn, McClintock Scott D, Malhotra Neil R
Department of Neurosurgery, Perelman School of Medicine University of Pennsylvania, Philadelphia, Pennsylvania, United States.
Department of Mathematics, West Chester University of Pennsylvania, West Chester, Pennsylvania, United States.
J Neurol Surg B Skull Base. 2021 Feb 4;83(Suppl 2):e31-e39. doi: 10.1055/s-0040-1722664. eCollection 2022 Jun.
The objective of this study is to elucidate the impact of income on short-term outcomes in a cerebellopontine angle (CPA) tumor resection population. This is a retrospective regression analysis. This study was done at a single, multihospital, urban academic medical center. Over 6 years (from June 7, 2013, to April 24, 2019), 277 consecutive CPA tumor cases were reviewed. Outcomes studied included readmission, emergency department evaluation, unplanned return to surgery, return to surgery after index admission, and mortality. Univariate analysis was conducted among the entire population with significance set at a -value <0.05. The population was divided into quartiles based on median household income and univariate analysis conducted between the lowest (quartile 1 [Q1]) and highest (quartile 4 [Q4]) socioeconomic quartiles, with significance set at a -value <0.05. Stepwise regression was conducted to determine the correlations among study variables and to identify confounding factors. Regression analysis of 273 patients demonstrated decreased rates of unplanned reoperation ( = 0.015) and reoperation after index admission ( = 0.035) at 30 days with higher standardized income. Logistic regression between the lowest (Q1) and highest (Q4) socioeconomic quartiles demonstrated decreased unplanned reoperation ( = 0.045) and decreasing but not significant reoperation after index admission ( = 0.15) for Q4 patients. No significant difference was observed for other metrics of morbidity and mortality. Higher socioeconomic status is associated with decreased risk of unplanned reoperation following CPA tumor resection.
本研究的目的是阐明收入对桥小脑角(CPA)肿瘤切除患者短期预后的影响。 这是一项回顾性回归分析。 本研究在一家单一的、多医院的城市学术医疗中心进行。 在6年期间(从2013年6月7日至2019年4月24日),对277例连续的CPA肿瘤病例进行了回顾。 研究的预后指标包括再入院、急诊科评估、非计划重返手术、首次入院后重返手术以及死亡率。在整个人口中进行单因素分析,显著性设定为P值<0.05。根据家庭收入中位数将人群分为四分位数,并在最低(四分位数1 [Q1])和最高(四分位数4 [Q4])社会经济四分位数之间进行单因素分析,显著性设定为P值<0.05。进行逐步回归以确定研究变量之间的相关性并识别混杂因素。 对273例患者的回归分析表明,标准化收入较高时,30天非计划再次手术率(P = 0.015)和首次入院后再次手术率(P = 0.035)降低。最低(Q1)和最高(Q4)社会经济四分位数之间的逻辑回归表明,Q4患者非计划再次手术率降低(P = 0.045),首次入院后再次手术率降低但不显著(P = 0.15)。在其他发病率和死亡率指标方面未观察到显著差异。 较高的社会经济地位与CPA肿瘤切除术后非计划再次手术风险降低相关。