TY - JOUR
T1 - Race as an Independent Predictor of Temporal Delay in Time to Diagnosis and Treatment in Patients with Cervical Stenosis
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.
N1 - Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/12/1
Y1 - 2016/12/1
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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U2 - 10.1016/j.wneu.2016.08.070
DO - 10.1016/j.wneu.2016.08.070
M3 - Article
C2 - 27567581
AN - SCOPUS:84988598556
SN - 1878-8750
VL - 96
SP - 107
EP - 110
JO - World neurosurgery
JF - World neurosurgery
ER -