Black patients fare worse after lumbar spinal fusion, study says — 6 takeaways


Black patients had significantly worse outcomes than white patients after lumbar spinal fusion, according to a study published in Spine.

Researchers at New York-Presbyterian Hospital/Weill Cornell Medical Center in New York City studied discharge records for nearly 268,000 patients hospitalized for lumbar spinal fusion in California, Florida, New York, Maryland and Kentucky from 2007-14.

Six takeaways:

1. Black patients were more likely to be women, have low income, undergo emergency surgery, and be treated at safety-net hospitals that performed a lower volume of spinal fusion surgeries. They were also generally younger.

2. After adjusting for these differences, researchers found that black patients were 8 percent more likely to experience complications specific to spinal surgery and 14 percent more likely to have general postoperative complications.

3. With higher complication rates, more hospital days and higher costs, black patients were also at increased risk of 30- and 90-day hospital readmission.

4. Outcomes for black patients remained significantly worse than those of white patients after researchers adjusted for demographic variables, coexisting medical conditions, hospital conditions and surgical techniques.

5. Characteristics such as treatment location and higher rates of diabetes and obesity among black patients could influence the racial differences in outcomes, researchers said.

6. The study authors recommended that hospital systems and providers promote equity in care through employee educational programs on outcome disparities, as well as standardized, protocol-based programs addressing implicit bias.

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