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- Alexander O Aguirre, Jaims Lim, Cathleen C Kuo, Nicco Ruggiero, Manhal Siddiqi, Andre Monteiro, Ammad A Baig, Steven B Housley, Matthew J Recker, Veetai Li, and Renée M Reynolds.
- Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo , New York , USA.
- Neurosurgery. 2024 Jan 1; 94 (1): 108116108-116.
Background And ObjectivesSocial determinants of health (SDOH) are nonmedical factors that affect health outcomes. Limited investigation has been completed on the potential association of these factors to adverse outcomes in pediatric populations. In this study, the authors aimed to analyze the effects of SDOH disparities and their relationship with outcomes after brain tumor resection or biopsy in children.MethodsThe authors retrospectively reviewed the records of their center's pediatric patients with brain tumor. Black race, public insurance, median household income, and distance to hospital were the investigated SDOH factors. Univariate analysis was completed between number of SDOH factors and patient demographics. Multivariate linear regression models were created to identify coassociated determinants and outcomes.ResultsA total of 272 patients were identified and included in the final analysis. Among these patients, 81 (29.8%) had no SDOH disparities, 103 (37.9%) had 1, 71 (26.1%) had 2, and 17 (6.2%) had 3. An increased number of SDOH disparities was associated with increased percentage of missed appointments ( P = .002) and emergency room visits ( P = .004). Univariate analysis demonstrated increased missed appointments ( P = .01), number of postoperative imaging ( P = .005), and number of emergency room visits ( P = .003). In multivariate analysis, decreased median household income was independently associated with increased length of hospital stay ( P = .02).ConclusionThe SDOH disparities are prevalent and impactful in this vulnerable population. This study demonstrates the need for a shift in research focus toward identifying the full extent of the impact of these factors on postoperative outcomes in pediatric patients with brain tumor.Copyright © Congress of Neurological Surgeons 2023. All rights reserved.
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