1. Racial Disparities in Health Care Resource Utilization After Pediatric Cervical and/or Thoracic Spinal Injuries
- Author
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Margot Sarkozy, Mani Ratnesh S. Sandhu, Chris S. Hong, Michael L. DiLuna, Aladine A. Elsamadicy, Isaac G. Freedman, Dominick A. Tuason, Andrew B. Koo, John Havlik, Adam J. Kundishora, Astrid Hengartner, and Benjamin C. Reeves
- Subjects
Male ,medicine.medical_specialty ,Adolescent ,Thoracic spine ,Thoracic Vertebrae ,White People ,Cohort Studies ,Postoperative Complications ,Health care ,medicine ,Humans ,Healthcare Disparities ,Child ,Retrospective Studies ,Asian ,business.industry ,Infant ,Retrospective cohort study ,Health Status Disparities ,Hispanic or Latino ,Length of Stay ,medicine.disease ,United States ,Black or African American ,Socioeconomic Factors ,Spinal Injuries ,Child, Preschool ,Relative risk ,Emergency medicine ,Cohort ,Cervical Vertebrae ,Female ,Surgery ,Neurology (clinical) ,Diagnosis code ,business ,Resource utilization ,Pediatric trauma - Abstract
This study aimed to investigate the impact of race on hospital length of stay (LOS) and hospital complications among pediatric patients with cervical/thoracic injury.A retrospective cohort was performed using the 2017 admission year from 753 facilities utilizing the National Trauma Data Bank. All pediatric patients with cervical/thoracic spine injuries were identified using the ICD-10-CM diagnosis coding system. These patients were segregated by their race, non-Hispanic white (NHW), non-Hispanic black (NHB), non-Hispanic Asian (NHA), and Hispanic (H). Demographic, hospital variable, hospital complications, and LOS data were collected. A linear and logistic multivariate regression analysis was performed to determine the risk ratio for hospital LOS as well as complication rate, respectively.A total of 4,125 pediatric patients were identified. NHB cohort had a greater prevalence of cervical-only injuries (NHW: 37.39% vs. NHB: 49.93% vs. NHA: 34.29% vs. H: 38.71%, P0.001). While transport accident was most common injury etiology for both cohorts, NHB cohort had a greater prevalence of assault (NHW: 1.53% vs. NHB: 17.40% vs. NHA: 2.86% vs. H: 6.58%, P0.001) than the other cohorts. Overall complication rates were significantly higher among NHB patients (NHW: 9.39% vs. NHB: 15.12% vs. NHA: 14.29% vs. H: 13.60%, P0.001). Compared with the NHW cohort, NHB, NHA, and H had significantly longer hospital LOS (NHW: 6.15 ± 9.03 days vs. NHB: 9.24 ± 20.78 days vs. NHA: 9.09 ± 13.28 days vs. H: 8.05 ± 11.45 days, P0.001). NHB race was identified as a significant predictor of increased LOS on multivariate regression analysis (risk ratio: 1.14, 95% confidence interval: 0.46, 1.82; P = 0.001) but not hospital complications (P = 0.345).Race may significantly impact health care resource utilization following pediatric cervical/thoracic spinal trauma.
- Published
- 2021