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Racial Disparities in Outcomes After Spine Surgery: A Systematic Review and Meta-Analysis.

Imad S Khan1, Elijah Huang2, Walker Maeder-York2

  • 1Section of Neurosurgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA; Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA.

World Neurosurgery
|October 11, 2021
PubMed
Summary

Black patients face higher risks for mortality, longer hospital stays, and non-home discharges after spinal surgery compared to white patients. Addressing these racial disparities in spine surgery outcomes is crucial for equitable healthcare.

Keywords:
DisparitiesOutcomesSocioeconomicSpine surgery

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Area of Science:

  • Health Services Research
  • Surgical Outcomes
  • Health Equity

Background:

  • Racial disparities in healthcare are a significant concern.
  • The extent of these disparities in spinal surgery outcomes is not well understood.

Purpose of the Study:

  • To systematically review and meta-analyze racial disparities in outcomes among patients undergoing surgery for degenerative spine disease.
  • To quantify differences in mortality, length of stay, discharge disposition, and readmission rates between racial groups.

Main Methods:

  • Systematic review and meta-analysis of studies published up to January 20, 2021.
  • Searched databases including Ovid MEDLINE, Scopus, and Cochrane Review.
  • Included 30 studies, with meta-analysis data from 20 cohort studies (3,501,830 patients).

Main Results:

  • Black patients had a 55% higher risk of mortality post-spine surgery compared to white patients.
  • Black patients experienced longer hospital stays (0.93 days), higher rates of non-home discharge (RR 1.63), and 30-day readmission (RR 1.45).
  • No significant differences were found in complication or reoperation rates between racial groups.

Conclusions:

  • Black patients face significantly higher risks of adverse outcomes after spinal surgery.
  • Further research is needed to understand the underlying causes of these racial disparities.
  • Developing targeted strategies is essential to reduce these outcome gaps in spine surgery.