Racial Differences in Perioperative Complications, Readmissions, and Mortalities After Elective Spine Surgery in the United States: A Systematic Review Using AI-Assisted Bibliometric Analysis.
meta_analysis · Level I
Where this comes from
- Record sourced from PubMed, PMID 37363960.
- Also identified by DOI 10.1177/21925682231186759 and PMC identifier 10802512.
- Licence recorded as CC BY-NC-ND.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
Systematic Review and Meta-analysis. To evaluate the impact of race on post-operative outcomes and complications following elective spine surgery in the United States. PUBMED, MEDLINE(R), ERIC, EMBASE, and SCOPUS were searched for studies documenting peri-operative events for White and African American (AA) patients following elective spine surgery. Pooled odds ratios were calculated for each 90-day outcome and meta-analyses were performed for 4 peri-operative events and 7 complication categories. Sub-analyses were performed for each outcome on single institution (SI) studies and works that included <100,000 patients. 53 studies (5,589,069 patients, 9.8% AA) were included. Eleven included >100,000 patients. AA patients had increased rates of 90-day readmission (OR 1.33, <i>P</i> = .0001), non-routine discharge (OR 1.71, <i>P</i> = .0001), and mortality (OR 1.66, <i>P</i> = .0003), but not re-operation (OR 1.16, <i>P</i> = .1354). AA patients were more likely to have wound-related complications (OR 1.47, <i>P</i> = .0001) or medical complications (OR 1.35, <i>P</i> = .0006), specifically cardiovascular (OR 1.33, <i>P</i> = .0126), deep vein thrombosis/pulmonary embolism (DVT/PE) (OR 2.22, <i>P</i> = .0188) and genitourinary events (OR 1.17, <i>P</i> = .0343). SI studies could only detect racial differences in re-admissions and non-routine discharges. Studies with <100,000 patients replicated the above findings but found no differences in cardiovascular complications. Disparities in mortality were only detected when all studies were included. AA patients faced a greater risk of morbidity across several distinct categories of peri-operative events. SI studies can be underpowered to detect more granular complication types (genitourinary, DVT/PE). Rare events, such as mortality, require larger sample sizes to identify significant racial disparities.