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  • Beyond biology: Impact of Marital Status and Socio-Economic-Index on Outcomes of Spinal Cord Tumors, Analysis from A National Cancer Registry.

    Final Number:

    Mohammed Ali Alvi MD; Waseem Wahood MS; Panagiotis Kerezoudis; F.M Moinuddin MBBS, Ph.D; Sandy Goncalves; Yagiz Ugur Yolcu; Mohamed Elminawy MBBCh; Anshit Goyal MBBS; Redab Alkhataybeh; Mohamad Bydon MD

    Study Design:

    Subject Category:

    Meeting: Section on Disorders of the Spine and Peripheral Nerves Spine Summit 2018

    Introduction: The impact of marital-status and living arrangement on health through modified health behaviours and social networks has been well-established in the literature with many experts claiming a “protective” effect that married life confers to individuals. Herein, we sought to study the impact of marital and socio-economic-status(SES) on outcomes of spinal-cord tumors.

    Methods: Surveillance, Epidemiology and End Results (SEER) program was utilized for abstracting patients with spinal cord tumors between 2004 and 2014. Patients were grouped into 4 groups based on their marital status: single/never married, married/living together, divorced/separated and widowed. Socio-economic status was calculated using a validated methodology. Kaplan-meier curves and multivariable logistic and cox regression were used to investigate the relationship between marital and socio-economic status and mortality rate of patients with available follow-up information.

    Results: A total of 1188 patients with spinal tumors were identified, of which 683(57.5%) were female and 505(42.5%) were male. Patients were categorized into four groups: 241(20.3%) single patients, 732(61.6%) married patients/patients with domestic partner, 109(9.2%) divorced/separated patients, and 106 (8.9%) widowed patients. Compared to married patients, divorced/separated and widowed patients had a higher mortality rate (HR:1.76, 95% CI:1.1 to 2.9, p= 0.02 and HR:2.01, 95% CI:1.3 to 3.1, p= 0.001 respectively). Male patients, compared to female patients, were associated with lower survival (HR: 1.42, 95% CI:1.03 to 1.9, p=0.03). Lastly, patients belonging to higher SES were found to have a lower mortality rate (HR: 0.77, CI 0.55-1.08, p=0.143).

    Conclusions: Consistent with other studies, unmarried and widowed patients, patients belonging to lower SES, and male patients were found to have a higher risk of mortality. Thus, these factors should be accounted for while tailoring the treatment plan for such patients.

    Patient Care: Our research will help physicians, oncologists surgeons involved in care of patients with spinal cord tumors to be cognizant of social factors that could play a role in factors like treatment adherence and consequentially, clinical outcomes.

    Learning Objectives: By the conclusion of this session, participants should be able to: 1) Discuss the potential of using a national cancer registry to study outcomes of common tumors. 2) Discuss the role of marital status on outcomes of spinal cord tumors


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