Roxanna M Garcia1, Seungwon Yoon2, Matthew B Potts3, Michael T Lawton2. 1. Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA. 2. Department of Neurological Surgery, Center for Cerebrovascular Research, University of California at San Francisco, San Francisco, California, USA. 3. Department of Neurosurgery, Northwestern University, Chicago, Illinois, USA. Electronic address: mpotts@nm.org.
Abstract
BACKGROUND: The objective of this study is to classify patients using federally mandated categories of ethnicity and race and to determine whether subgroups are associated with patient outcomes and aneurysmal subarachnoid hemorrhage (SAH). METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2013 was used to identify patients undergoing treatment of an intracerebral aneurysm. Ethnicity and race were combined to create subgroups. A descriptive statistical analysis was performed and a multivariable logistic regression model was tested whether ethnic and racial subgroups were associated with SAH. RESULTS: A total of 686 patients met the study criteria. There were no endovascular cases reported. Four subgroups were identified, which included non-Hispanic Whites (n = 504, 73.47%, NH Whites), Hispanic Whites (n = 38, 5.54%), non-Hispanic Blacks (n = 109, 15.89%, NH Blacks), and non-Hispanic Asians (n = 35, 5.10%, NH Asians). Significant statistical associations were found between subgroups and the following baseline variables: age, female gender, body mass index, smoking, and treated hypertension (all P < 0.01). The NH Whites had the lowest proportion of SAH diagnosis (30.91%), which was statistically significant (P < 0.001). Multivariable logistic regression model adjusted for age, smoking, female gender, hypertension, and multiple comparisons found a statistically significant difference only between NH Asians compared with NH Whites (odds ratio = 1.25, 95% confidence interval 0.25-2.29, P < 0.01). Postoperative outcomes were similar across ethnic and racial subgroups. CONCLUSIONS: There are differences in baseline characteristics and the proportion of SAH. Future studies must take into account risk factors and outcomes not reported in the database. Copyright Â
BACKGROUND: The objective of this study is to classify patients using federally mandated categories of ethnicity and race and to determine whether subgroups are associated with patient outcomes and aneurysmal subarachnoid hemorrhage (SAH). METHODS: The American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2013 was used to identify patients undergoing treatment of an intracerebral aneurysm. Ethnicity and race were combined to create subgroups. A descriptive statistical analysis was performed and a multivariable logistic regression model was tested whether ethnic and racial subgroups were associated with SAH. RESULTS: A total of 686 patients met the study criteria. There were no endovascular cases reported. Four subgroups were identified, which included non-Hispanic Whites (n = 504, 73.47%, NH Whites), Hispanic Whites (n = 38, 5.54%), non-Hispanic Blacks (n = 109, 15.89%, NH Blacks), and non-Hispanic Asians (n = 35, 5.10%, NH Asians). Significant statistical associations were found between subgroups and the following baseline variables: age, female gender, body mass index, smoking, and treated hypertension (all P < 0.01). The NH Whites had the lowest proportion of SAH diagnosis (30.91%), which was statistically significant (P < 0.001). Multivariable logistic regression model adjusted for age, smoking, female gender, hypertension, and multiple comparisons found a statistically significant difference only between NH Asians compared with NH Whites (odds ratio = 1.25, 95% confidence interval 0.25-2.29, P < 0.01). Postoperative outcomes were similar across ethnic and racial subgroups. CONCLUSIONS: There are differences in baseline characteristics and the proportion of SAH. Future studies must take into account risk factors and outcomes not reported in the database. Copyright Â