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  • Racial and Socioeconomic Disparities in Occurrence of Hospital Acquired Complications Following Cerebrovascular Surgery

    Final Number:

    Timothy Wen MPH; Frank Attenello MD MS; Shuhan He BS; Eisha Christian MD; Steven Y Cen PhD; May Kim-Tenser MD; Nerses Sanossian MD; Arun Paul Amar MD; William J. Mack MD

    Study Design:

    Subject Category:

    Meeting: AANS/CNS Cerebrovascular Section 2014 Annual Meeting

    Introduction: Patients with cerebrovascular disease undergo complex surgical procedures, often requiring prolonged inpatient hospitalization. Prior studies have demonstrated associations between racial/demographic factors and clinical outcomes in patients undergoing cerebrovascular procedures (CVPs). The Centers for Medicare and Medicaid Services (CMS) have published a series of 11 hospital acquired conditions (HACs) deemed “reasonably preventable” for which related costs of treatment are not reimbursed. We hypothesize that race and payer status disparities impact HAC frequency in patients undergoing CVPs and that HAC occurrence affects length of stay and hospital cost

    Methods: Data was collected from the Nationwide Inpatient Sample (NIS) database from 2002-2010. Patients undergoing cerebrovascular procedures were identified by ICD-9 code. HAC occurrence was evaluated according to demographics including race, payer status, and median zip code income via multivariable analysis. Secondary outcomes of interest included length of stay and resulting inpatient charges.

    Results: Significant disparities in HAC frequency existed according to ethnicity and insurance provider. Minorities and Medicaid patients had increased frequency of HACs (p<0.05), as well as prolonged length of stay and higher inpatient costs (p<0.05).

    Conclusions: HAC occurrence is associated with racial and socioeconomic factors in patients who undergo cerebrovascular procedures. Improved processes and protocol implementation may help to decrease the frequency of these potentially avoidable events.

    Patient Care: Elucidating role of race and socioeconomic factors and a specific subgroup that may benefit from further consideration given propensity for hospital acquired conditions

    Learning Objectives: By the conclusion, participants should have 1) An Understanding impact of Hospital acquired conditions on Length of Stay and Hospital costs, 2) Evaluated race and socioeconomic factors on HAC rate


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