Analysis of socioeconomic and demographic factors on post-treatment outcomes for metastatic spinal tumors

• Published in: Clinical neurology and neurosurgery Vol. 225; p. 107581
• Main Authors: Larkin, Collin J., Thirunavu, Vineeth M., Nahi, Skylar L., Roumeliotis, Anastasios G., Shlobin, Nathan A., Kandula, Viswajit, Shah, Parth V., Chan, Kyle S., Yerneni, Ketan, Abecassis, Zachary A., Karras, Constantine L., Dahdaleh, Nader S.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.02.2023; Elsevier Limited
• Subjects: Body mass index; Bone cancer; Cancer; Central Nervous System Neoplasms; Chi-square test; Comorbidity; Demographics; Demography; Educational attainment; Family income; Fecal incontinence; Female; Health care; Hospitals; Humans; Length of Stay; Low income groups; Male; Males; Metastases; Metastasis; Metastatic spinal tumors; Neurology; Patients; Post-treatment outcomes; Postal codes; Redlining; Regression analysis; Retrospective Studies; Sociodemographics; Socioeconomic Factors; Socioeconomics; Software; Spinal cancer; Spinal Cord Neoplasms; Spinal Neoplasms - epidemiology; Spinal Neoplasms - secondary; Spinal Neoplasms - surgery; Spine - surgery; Surgery; Treatment Outcome; Tumors; United States > US; Chicago Illinois; Post-treatment outcomes; Demographics; Metastatic spinal tumors; Socioeconomics
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2022.107581

Sociodemographic factors may play a role in incidence and treatment of metastatic spinal tumors, as there is a delay in diagnosis and increased incidence of relevant primaries. There has yet to be a detailed analysis of the impact of sociodemographic factors on surgical outcomes for spinal metastases. We sought to examine the influence of socioeconomic factors on outcomes for patients with metastatic spinal tumors. Two hundred and sixty-three patients who underwent surgery for metastatic spinal tumors were identified. Sociodemographic characteristics were then collected and assigned to patients based on their ZIP code. The Chi-square test and the Mann-Whitney-U test were used for binary and continuous variables, respectively. Multivariate regression models were also used to control for age, smoking status, body mass index, and Charlson Comorbidity Index. Males had significantly lower rates of post-treatment complication compared to females (22.7 % vs 39.3 %, p = 0.0052), and those in high educational attainment ZIP codes had significantly shorter length of stay (LOS) compared to low educational attainment ZIP codes (9.3 days vs 12.2 days, p = 0.0058). Multivariate regression revealed that living in a high percentage white ZIP code and being male significantly decreased risk of post-treatment complication by 19 % (p = 0.042) and 14 % (p = 0.032), respectively. Living in a high educational attainment ZIP code decreased LOS by 3 days (p = 0.019). Males had significantly lower rates of post-treatment complication. Patients in high percentage white areas also had decreased rate of post-treatment complications. Patients living in areas with high educational attainment had shorter length of stay. •SES factors significantly correlated with important post-surgical outcomes.•Controlled for multiple confounders in rigorous multivariate analyses.•Outcomes include length of stay and post-treatment complications.