Elsamadicy Aladine A, Serrato Paul, Ghanekar Shaila D, Sadeghzadeh Sina, Hansen Justice, Mitre Lucas P, Lo Sheng-Fu Larry, Sciubba Daniel M
Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States.
Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, United States.
Clin Neurol Neurosurg. 2025 Jul;254:108931. doi: 10.1016/j.clineuro.2025.108931. Epub 2025 May 2.
This study aimed to evaluate the impact of race/ethnicity on postoperative adverse events (AEs), prolonged length of stay (LOS), non-routine discharge (NRD), and unplanned readmission in spine surgery patients.
A retrospective cohort study was performed using the 2016-2023 ACS NSQIP database. Adults receiving spine surgery for trauma, degenerative disease, tumor, and infectious causes were identified using CPT codes and stratified based on race/ethnicity. The primary categories included Non-Hispanic White, Non-Hispanic Black, Non-Hispanic Asian, and Hispanic patients. Patient demographics, comorbidities, intraoperative variables, postoperative AEs, and healthcare resource utilization were assessed. Multivariate logistic regression analysis was utilized to identify predictors of AEs, prolonged LOS, NRD, and unplanned admission.
In our cohort of 402,765 patients, postoperative outcomes displayed significant ethnic disparities in AEs, with the highest in Non-Hispanic Blacks (p < 0.001). Similarly, Non-Hispanic Blacks had prolonged operation times and increased rates of unplanned readmissions and reoperations (all p < 0.001). Multivariate analysis showed Non-Hispanic Blacks had an increased risk for extended LOS (aOR: 1.83, 95 % CI: 1.78-1.88, p < 0.001) and AEs (aOR: 1.10, 95 % CI: 1.06-1.15, p < 0.001). Non-Hispanic Blacks (aOR: 1.84, 95 % CI: 1.78-1.90, p < 0.001), Non-Hispanic Asians (aOR: 1.14, 95 % CI: 1.07-1.21, p < 0.001), and Hispanics (aOR: 1.48, 95 % CI: 1.43-1.54, p < 0.001) had higher odds of NRD. For unplanned readmissions, Non-Hispanic Blacks (aOR: 1.13, 95 % CI: 1.08-1.19, p < 0.001) had increased odds, while Non-Hispanic Asians showed decreased odds (aOR: 0.80, 95 % CI: 0.72-0.90, p < 0.001).
Our study demonstrates prominent racial/ethnic disparities in postoperative outcomes among spine surgery patients, with particularly elevated risks observed in Non-Hispanic Black individuals.
