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World Neurosurg ; 156: e307-e318, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34560297

RESUMO

OBJECTIVE: 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. METHODS: 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. RESULTS: 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%, P < 0.001). 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%, P < 0.001) 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%, P < 0.001). 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, P < 0.001). 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). CONCLUSIONS: Race may significantly impact health care resource utilization following pediatric cervical/thoracic spinal trauma.


Assuntos
Vértebras Cervicais/lesões , Disparidades em Assistência à Saúde/estatística & dados numéricos , Traumatismos da Coluna Vertebral/terapia , Vértebras Torácicas/lesões , Adolescente , Negro ou Afro-Americano , Asiático , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Disparidades nos Níveis de Saúde , Hispânico ou Latino , Humanos , Lactente , Tempo de Internação , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Fatores Socioeconômicos , Traumatismos da Coluna Vertebral/epidemiologia , Traumatismos da Coluna Vertebral/cirurgia , Estados Unidos/epidemiologia , População Branca
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