title: Impact of Race on 30-Day Complication Rates After Elective Complex Spinal Fusion (≥5 Levels): A Single Institutional Study of 446 Patients.
abstract: OBJECTIVE
  Racial disparities have been shown to affect surgical outcomes. However, the effect of race on complex spinal fusion outcomes remains understudied. The aim of this study is to determine if patient race affects 30-day complication rates after elective complex spinal fusion (≥5 levels).
  
  
  METHODS
  The medical records of 490 adult patients with spinal deformity undergoing elective complex spinal fusion (≥5 levels) at a major academic institution from 2005 to 2015 were reviewed. We identified 52 black patients (11.7%) and 438 white patients (88.3%). Patient demographics, comorbidities, and intraoperative and 30-day postoperative complication and readmission rates were collected. The primary outcome investigated in this study was the rate of 30-day postoperative complications.
  
  
  RESULTS
  Patient demographics and comorbidities were similar between both groups, including age, gender, and body mass index. Median (interquartile range) number of fusion levels and operative time were similar between the cohorts (black, 6.5 [5-9] vs. white, 7 [5-9]; P = 0.55; and black, 307.3 ± 120.2 minutes vs. white, 321.3 ± 135.3 minutes; P = 0.45, respectively). Both cohorts had similar postoperative complications and lengths of hospital stay (black, 7.2 ± 5.4 days vs. white: 6.5 ± 4.9; P = 0.37). There was no significant difference in 30-day readmission between the cohorts (black, 9.6% vs. white, 12.8%; P = 0.66). There were no observed differences in 30-day complication rates, including: pain (P = 0.74), urinary tract infection (P = 0.68), hardware failure (P = 0.36), wound dehiscence (P = 0.29), and drainage (P = 0.86).
  
  
  CONCLUSIONS
  Our study suggests that there is no difference between races in 30-day complication and readmission rates after complex spinal surgery requiring ≥5 levels of fusion.
authors.affiliation: Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Aladine A
authors.initials: AA
authors.lastname: Elsamadicy
authors.affiliation: Department of Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA. Electronic address: owoicho.adogwa@gmail.com.
authors.forename: Owoicho
authors.initials: O
authors.lastname: Adogwa
authors.affiliation: Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Sergesketter
authors.affiliation: Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Cassie
authors.initials: C
authors.lastname: Hobbs
authors.affiliation: Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Shay
authors.initials: S
authors.lastname: Behrens
authors.affiliation: Department of Neurosurgery, The University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Ankit I
authors.initials: AI
authors.lastname: Mehta
authors.affiliation: Department of Neurosurgery, University of Kentucky, Lexington, Kentucky, USA.
authors.forename: Raul A
authors.initials: RA
authors.lastname: Vasquez
authors.affiliation: Department of Neurosurgery, Yale University, New Haven, Connecticut, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Cheng
authors.affiliation: Department of Neurosurgery, University of Texas Southwestern, Dallas, Texas, USA.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Bagley
authors.affiliation: Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Isaac O
authors.initials: IO
authors.lastname: Karikari
mesh_terms: D001741:Black or African American; D000368:Aged; D017558:Elective Surgical Procedures; D004868:Equipment Failure / Q000706:statistics & numerical data; D005006:Ethnicity; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007431:Intraoperative Complications / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010149:Postoperative Pain / Q000208:ethnology; D010359:Patient Readmission; D011183:Postoperative Complications / Q000208:ethnology*; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion; D013529:Surgical Wound Dehiscence / Q000208:ethnology; D014552:Urinary Tract Infections / Q000208:ethnology*; D044465:White People
keywords: Postoperative complications; Race; Spinal fusion; Spine