Racial Differences in Hospital Stays among Patients Undergoing Craniotomy for Tumour Resection at a Single Academic Hospital

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Racial Differences in Hospital Stays among Patients Undergoing Craniotomy for Tumour Resection at a Single Academic Hospital

Study design and selection of patients

We conducted a retrospective cross-sectional study that included adult patients (18 years or older) who underwent craniotomy for brain tumour resection at a single academic medical centre in Los Angeles, California from March 2013 to January 2017. Patients were selected using International Classification of Diseases, 9th and 10th Revision and Current Procedural Terminology, version 4 codes. Informed consent was obtained from all individual participants included in the study. The study had prior approval from our institutional review board and ethics committee before data collection was initiated (IRB approval number 17-000579).

Background

Racial differences in American patients undergoing brain tumour surgery remain poorly characterized within urban medical centres. Our objective was to assess racial differences in operative brain tumour patients at a single academic hospital in Los Angeles, California.

Results

In this study, 462 patients identified as Asian (15.1%), Hispanic (8.7%), Black (3.9%), or White (72.3%). After cohort matching, non-White patients had elevated risk of prolonged LOS [odds ratio (OR)=2.62 (1.44, 4.76)]. No differences were observed in hospital mortality or non-routine discharge. Longer LOS was positively correlated with non-routine discharge [rpb (458)=0.41, p<0.001]. Black patients with government insurance had average LOS 2.84 days shorter than Black patients with private insurance (p=0.04). Among Hispanics, government insurance was associated with non-routine discharge [OR=4.93 (1.03, 24.00)].

Conclusion

Racial differences manifested as extended LOS for non-White patients, with comparable rates of hospital mortality and non-routine discharge across races. Prolonged LOS loosely reflected complicated clinical course with greater risk of adverse discharge disposition. Private insurance coverage predicted markedly lower risk of non-routine discharge for Hispanic patients, and LOS of three additional days among Black patients. Further research is needed to elucidate the basis of these differences.

Best Regards:
Mary Wilson
Journal Manager

Journal of Tumor Research
Email: tumour@medicalresjournals.com