Racial and Ethnic Health Disparities Following Spine Surgery: ACS-NSQIP Review From 2015 to 2020

Area of Science:

• Surgical Outcomes Research
• Health Disparities
• Spine Surgery

Background:

• Postoperative complications after spine surgery can vary significantly.
• Understanding the impact of race and ethnicity (R&E) on these outcomes is crucial for addressing health inequities.

Purpose of the Study:

• To investigate if R&E are independent predictors of postoperative complications following spine surgery.
• To identify specific R&E groups at higher risk for adverse outcomes.

Main Methods:

• Retrospective analysis of the National Surgical Quality Improvement Program (NSQIP) database.
• Comparison of demographic, comorbidity, and complication data across racial and ethnic groups using chi-square and Kruskal-Wallis tests.
• Logistic and linear regression analyses controlled for age, weight, sex, and comorbidities to assess R&E as independent predictors.

Main Results:

• Analysis included 181,913 White, 21,501 Black, 10,710 Hispanic, 5611 Asian, 1249 Native American (NA), and 628 Native Hawaiian (NH) patients.
• Black patients showed higher rates of dyspnea, diabetes, and hypertension, and increased odds of respiratory, urinary, cardiovascular, and septic complications compared to White patients.
• Hispanic and Native American patients had higher odds of certain complications, while Asian patients had lower odds of respiratory and cardiovascular complications.

Conclusions:

• Race and ethnicity are significant predictors of postoperative complication disparities in spine surgery.
• Black, Hispanic, and Native American patients exhibit increased odds of complications, highlighting a need for targeted interventions.
• Perioperative care strategies must be developed to mitigate these disparities and promote health equity in spine surgery outcomes.