Introduction: Racial disparities are becoming increasingly important as new healthcare policies become instituted. It is important become more familiar with racial difference in patients undergoing spine surgery.
Methods: Patients were identified by CPT (Current Procedural Terminology) code in the American College of Surgeon’s National Surgical Quality Improvement Program (ACS-NSQIP) database. A univariate analysis was performed to compare demographics, comorbidities, operative and postoperative complications across Hispanics, Blacks and Whites. Multivariate stepwise logistic regression was performed on complications that demonstrated significant association to race in the univariate comparison. Perioperative variables with P<0.2 were included in the multivariate analyses. White race was set as the reference for the race category. Level of significance was set at P=0.05.
Results: Black (10.2%) and Hispanic (8.5%) patients were more likely to be identified as obesity class III when compared to White patients (7.3%) (p < 0.0001). Hispanics (7.8%) were more like to have dependent functional status prior to surgery when compared to Blacks (5.0%) or Whites (3.97%)(p=0.004). White and Black patients more commonly underwent multilevel fusion when compared to Hispanics, respectively (31.34% vs. 31.30% vs. 23.86%, p=0.014). Only wound complications were significantly different amongst the three races with patients of Black race (4.3%) experiencing a greater rate than patients of Hispanic (2.61%) or White race (2.19%) (p=0.027). Patients of Black (23.16%) and Hispanic (22.88%) race experienced length of stay (LOS) >5 days more commonly than Whites (16.75%)(p=0.0002). Multivariate did not show race to be an independent predictor of wound complications.
Conclusions: Although Blacks and Hispanics may present with increased rate of wound complications, race is not independent predictor of this outcome. More research is needed in this area.
Patient Care: This work will help physicians better understand the impact of race on wound complications in posterior lumbar fusion. Better understanding of risk factors for posterior lumbar fusion surgery is necessary for improving patient care and stratifying risk appropriately.
Learning Objectives: By the conclusion of this session, participants should be able to understand if race is an independent risk factor for wound complications in posterior lumbar fusion.