Race as an Independent Predictor of Temporal Delay in Time to Diagnosis and Treatment in Patients with Cervical Stenosis: A Study of 133 Patients with Anterior Cervical Discectomy and Fusion

Aladine A. Elsamadicy, Owoicho Adogwa, Jared Fialkoff, Ankit I. Mehta, Raul A. Vasquez, Joseph Cheng, Carlos A. Bagley, Isaac O. Karikari

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Prompt decompression in clinically significant cervical stenosis is important in the prevention of neurological sequelae. Disparities exist along the continuum on spine care, with black patients receiving less surgery and experiencing worse postoperative outcomes. The aim of this study was to assess whether black race was an independent predictor for a prolonged time to diagnosis and treatment. Methods The medical records of 133 patients undergoing elective anterior cervical discectomy and fusion surgery at a major academic medical center between 2010 and 2012 were reviewed. All patients had prospectively collected patient-reported outcomes measures including visual analogue scale (VAS) of pain. Data on patient demographics, comorbidities, and postoperative complication rates were retrospectively collected. Multivariate analysis was performed on variables that trended with delay in diagnosis and treatment on univariate analysis to determine independent predictors of delay in diagnosis and treatment. Results Patient demographics of the cohort included 45.87% male, 80.30% white, 71.97% married, 53.72% employed, 18.8% with a history of depression, and 19.55% with anxiety. The mean ± standard deviation age was 54.02 ± 11.74 years and baseline VAS-neck pain was 4.87 ± 3.19. In a multivariate analysis, race was the only statistically significant variable (P = 0.0212) to predict increased duration of preoperative pain before treatment. Other variables in the model included depression, anxiety, age, gender, employment status, marital status, body mass index, and baseline VAS-neck pain score. Conclusions Our study demonstrates that race is an independent risk factor for a temporal delay in diagnosis and treatment of symptomatic cervical stenosis.

Original languageEnglish (US)
Pages (from-to)107-110
Number of pages4
JournalWorld Neurosurgery
Volume96
DOIs
StatePublished - Dec 1 2016

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Diskectomy
Pathologic Constriction
Neck Pain
Visual Analog Scale
Multivariate Analysis
Anxiety
Demography
Depression
Therapeutics
Marital Status
Pain Measurement
Decompression
Medical Records
Comorbidity
Spine
Body Mass Index
Pain

Keywords

  • Complications
  • Independent predictor
  • Multivariate analysis
  • Patient-reported outcomes
  • Race
  • Spine surgery

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Race as an Independent Predictor of Temporal Delay in Time to Diagnosis and Treatment in Patients with Cervical Stenosis : A Study of 133 Patients with Anterior Cervical Discectomy and Fusion. / Elsamadicy, Aladine A.; Adogwa, Owoicho; Fialkoff, Jared; Mehta, Ankit I.; Vasquez, Raul A.; Cheng, Joseph; Bagley, Carlos A.; Karikari, Isaac O.

In: World Neurosurgery, Vol. 96, 01.12.2016, p. 107-110.

Research output: Contribution to journalArticle

Elsamadicy, Aladine A. ; Adogwa, Owoicho ; Fialkoff, Jared ; Mehta, Ankit I. ; Vasquez, Raul A. ; Cheng, Joseph ; Bagley, Carlos A. ; Karikari, Isaac O. / Race as an Independent Predictor of Temporal Delay in Time to Diagnosis and Treatment in Patients with Cervical Stenosis : A Study of 133 Patients with Anterior Cervical Discectomy and Fusion. In: World Neurosurgery. 2016 ; Vol. 96. pp. 107-110.
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abstract = "Background Prompt decompression in clinically significant cervical stenosis is important in the prevention of neurological sequelae. Disparities exist along the continuum on spine care, with black patients receiving less surgery and experiencing worse postoperative outcomes. The aim of this study was to assess whether black race was an independent predictor for a prolonged time to diagnosis and treatment. Methods The medical records of 133 patients undergoing elective anterior cervical discectomy and fusion surgery at a major academic medical center between 2010 and 2012 were reviewed. All patients had prospectively collected patient-reported outcomes measures including visual analogue scale (VAS) of pain. Data on patient demographics, comorbidities, and postoperative complication rates were retrospectively collected. Multivariate analysis was performed on variables that trended with delay in diagnosis and treatment on univariate analysis to determine independent predictors of delay in diagnosis and treatment. Results Patient demographics of the cohort included 45.87{\%} male, 80.30{\%} white, 71.97{\%} married, 53.72{\%} employed, 18.8{\%} with a history of depression, and 19.55{\%} with anxiety. The mean ± standard deviation age was 54.02 ± 11.74 years and baseline VAS-neck pain was 4.87 ± 3.19. In a multivariate analysis, race was the only statistically significant variable (P = 0.0212) to predict increased duration of preoperative pain before treatment. Other variables in the model included depression, anxiety, age, gender, employment status, marital status, body mass index, and baseline VAS-neck pain score. Conclusions Our study demonstrates that race is an independent risk factor for a temporal delay in diagnosis and treatment of symptomatic cervical stenosis.",
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T2 - A Study of 133 Patients with Anterior Cervical Discectomy and Fusion

AU - Elsamadicy, Aladine A.

AU - Adogwa, Owoicho

AU - Fialkoff, Jared

AU - Mehta, Ankit I.

AU - Vasquez, Raul A.

AU - Cheng, Joseph

AU - Bagley, Carlos A.

AU - Karikari, Isaac O.

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N2 - Background Prompt decompression in clinically significant cervical stenosis is important in the prevention of neurological sequelae. Disparities exist along the continuum on spine care, with black patients receiving less surgery and experiencing worse postoperative outcomes. The aim of this study was to assess whether black race was an independent predictor for a prolonged time to diagnosis and treatment. Methods The medical records of 133 patients undergoing elective anterior cervical discectomy and fusion surgery at a major academic medical center between 2010 and 2012 were reviewed. All patients had prospectively collected patient-reported outcomes measures including visual analogue scale (VAS) of pain. Data on patient demographics, comorbidities, and postoperative complication rates were retrospectively collected. Multivariate analysis was performed on variables that trended with delay in diagnosis and treatment on univariate analysis to determine independent predictors of delay in diagnosis and treatment. Results Patient demographics of the cohort included 45.87% male, 80.30% white, 71.97% married, 53.72% employed, 18.8% with a history of depression, and 19.55% with anxiety. The mean ± standard deviation age was 54.02 ± 11.74 years and baseline VAS-neck pain was 4.87 ± 3.19. In a multivariate analysis, race was the only statistically significant variable (P = 0.0212) to predict increased duration of preoperative pain before treatment. Other variables in the model included depression, anxiety, age, gender, employment status, marital status, body mass index, and baseline VAS-neck pain score. Conclusions Our study demonstrates that race is an independent risk factor for a temporal delay in diagnosis and treatment of symptomatic cervical stenosis.

AB - Background Prompt decompression in clinically significant cervical stenosis is important in the prevention of neurological sequelae. Disparities exist along the continuum on spine care, with black patients receiving less surgery and experiencing worse postoperative outcomes. The aim of this study was to assess whether black race was an independent predictor for a prolonged time to diagnosis and treatment. Methods The medical records of 133 patients undergoing elective anterior cervical discectomy and fusion surgery at a major academic medical center between 2010 and 2012 were reviewed. All patients had prospectively collected patient-reported outcomes measures including visual analogue scale (VAS) of pain. Data on patient demographics, comorbidities, and postoperative complication rates were retrospectively collected. Multivariate analysis was performed on variables that trended with delay in diagnosis and treatment on univariate analysis to determine independent predictors of delay in diagnosis and treatment. Results Patient demographics of the cohort included 45.87% male, 80.30% white, 71.97% married, 53.72% employed, 18.8% with a history of depression, and 19.55% with anxiety. The mean ± standard deviation age was 54.02 ± 11.74 years and baseline VAS-neck pain was 4.87 ± 3.19. In a multivariate analysis, race was the only statistically significant variable (P = 0.0212) to predict increased duration of preoperative pain before treatment. Other variables in the model included depression, anxiety, age, gender, employment status, marital status, body mass index, and baseline VAS-neck pain score. Conclusions Our study demonstrates that race is an independent risk factor for a temporal delay in diagnosis and treatment of symptomatic cervical stenosis.

KW - Complications

KW - Independent predictor

KW - Multivariate analysis

KW - Patient-reported outcomes

KW - Race

KW - Spine surgery

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