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Journal of Neurosurgical Sciences 2021 Aug 03

DOI: 10.23736/S0390-5616.21.05246-2

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Household income is associated with return to surgery following discectomy for far lateral disc herniation

Austin J. BORJA 1, John CONNOLLY 1, Svetlana KVINT 1, Donald K. DETCHOU 1, Gregory GLAUSER 1, Krista STROUZ 2, 3, Scott D. McCLINTOCK 3, Paul J. MARCOTTE 1, Neil R. MALHOTRA 1

1 Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; 2 McKenna EpiLog Fellowship in Population Health at the University of Pennsylvania, Philadelphia, PA, USA; 3 West Chester University, The West Chester Statistical Institute and Department of Mathematics, West Chester, PA, USA


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BACKGROUND: Numerous studies have demonstrated that household income is independently predictive of postsurgical morbidity and mortality, but few studies have elucidated this relationship in a purely spine surgery population. This study aims to correlate household income with adverse events after discectomy for far lateral disc herniation (FLDH).
METHODS: All adult patients (n = 144) who underwent FLDH surgery at a single, multihospital, 1659-bed university health system (2013-2020) were retrospectively analyzed. Univariate logistic regression was used to evaluate the relationship between household income and adverse postsurgical events, including unplanned hospital readmissions, ED visits, and reoperations.
RESULTS: Mean age of the population was 61.72 ± 11.55 years. Mean household income was $78,283 ± 26,996; 69 (47.9%) were female; and 126 (87.5%) were non-Hispanic white. Ninety-two patients underwent open and fifty-two underwent endoscopic FLDH surgery. Each additional dollar decrease in household income was significantly associated with increased risk of reoperation of any kind within 90-days, but not 30-days, after the index admission. However, household income did not predict risk of readmission or ED visit within either 30-days or 30-90-days post-surgery.
CONCLUSIONS: These findings suggest that household income may predict reoperation following FLDH surgery. Additional research is warranted into the relationship between household income and adverse neurosurgical outcomes.


KEY WORDS: Patient outcome assessment; Patient readmission; Intervertebral disc displacement; Discectomy; Income; Healthcare disparities

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