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脊柱疾病确诊患者的手术延迟:回顾性分析

Delayed surgery among patients diagnosed with spinal disorders: Retrospective analysis.

作者信息

Aglio Linda S, Examond Tayisha, Justice Samuel A, Mendez-Pino Laura, Mezzalira Elisabetta, Baez Leah A, Kelly-Aglio Nicole J, Fields Kara G, Jamison Robert N, Edwards Robert R, Corey Sarah M

机构信息

Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.

Department of Neurosurgery, Computational Neurosurgical Outcome Center, Brigham and Women's Hospital, Boston, Massachusetts, United States of America.

出版信息

PLoS One. 2025 Jun 30;20(6):e0325810. doi: 10.1371/journal.pone.0325810. eCollection 2025.

Abstract

To determine the association between race and access to healthcare services with respect to the treatment of spinal cord disorders, a retrospective cohort study of patients receiving an initial diagnosis, two Boston hospitals, September 1, 2017, to June 1, 2018, follow-up through December 31, 2019. Data from patients (18-89 years) diagnosed with spinal cord disorders were extracted retrospectively from a centralized database. Kaplan-Meier curves and multivariable Cox proportional hazards models analyzed the time to spine surgery following initial diagnosis. Patient race was the primary explanatory variable, with five racial groups (Asian, Black, Hispanic, Other, and White) based on a combination of their self-reported race and ethnicity. Hispanic ethnicity (regardless of race), non-Hispanic ethnicity (designated Asian, Black, or White), and "Other" (non-Hispanic patients who designated their race as other than Asian, Black, or White; this included American Indian, Alaska Native, Native Hawaiian or other Pacific Islander, or two or more races). Among 56,186 patients (4% Asian, 7% Black, 5% Hispanic, 6% Other, 77% White) meeting inclusion criteria, Asian (hazard ratio (HR) 0.67 (0.55, 0.82)), Black (HR 0.55 (0.47, 0.63)), Hispanic (HR 0.43 (0.35, 0.52)), and Other (HR 0.59 (0.51, 0.69)) patients had significantly longer times to surgery compared with White patients.

摘要

为了确定在脊髓疾病治疗方面种族与获得医疗服务之间的关联,我们进行了一项回顾性队列研究,研究对象为2017年9月1日至2018年6月1日在波士顿两家医院首次确诊的患者,并随访至2019年12月31日。从一个集中数据库中回顾性提取了18至89岁被诊断患有脊髓疾病患者的数据。采用Kaplan-Meier曲线和多变量Cox比例风险模型分析首次诊断后至脊柱手术的时间。患者种族是主要解释变量,根据自我报告的种族和民族组合分为五个种族群体(亚裔、黑人、西班牙裔、其他和白人)。西班牙裔民族(无论种族)、非西班牙裔民族(指定为亚裔、黑人或白人)以及“其他”(将种族指定为非亚裔、非黑人或非白人的非西班牙裔患者;这包括美洲印第安人、阿拉斯加原住民、夏威夷原住民或其他太平洋岛民,或两个或更多种族)。在符合纳入标准的56186名患者中(4%为亚裔,7%为黑人,5%为西班牙裔,6%为其他,77%为白人),与白人患者相比,亚裔(风险比(HR)0.67(0.55,0.82))、黑人(HR 0.55(0.47,0.63))、西班牙裔(HR 0.43(0.35,0.52))和其他(HR 0.59(0.51,0.69))患者的手术时间明显更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea5e/12208456/afda94898bcd/pone.0325810.g001.jpg

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