Abstract：
Race-based health care outcomes remain to be described in anterior cranial fossa (ACF) surgery.
To determine whether race predicts worse outcomes after ACF surgery.
A retrospective cohort study was performed using the American College of Surgeons National Surgical Quality Improvement Program data for 2005 to 2020. Current Procedural Terminology and International Classification of Diseases-9 codes were used to identify ACF tumor cases. Propensity score matching was performed to compare White and minority patients to assess the robustness of unmatched findings. A subanalysis of pituitary adenoma (PA) resections was also performed.
In an unmatched analysis of 1370 patients who underwent ACF surgery (67.9% White, 17.4% Black, 6.6% Asian/Pacific Islander, and 6.3% Hispanic), minority groups had higher rates of comorbidities. Unmatched multivariate analysis found Hispanic patients bore a 1.86 odds ratio (OR) of minor complications, Black and Asian and Pacific Islander patients bore 1.49 and 1.71 ORs, respectively, for extended length of stay, and Black patients bore a 3.78 OR for urinary tract infection (UTI). Matched analysis found that minority patients had higher UTI rates ( P = .02) and a 4.11 OR of UTI. In PA cases specifically, minority groups had higher comorbidities and length of stay in addition to extended length of stay odds (1.84 OR).
Although most ACF surgery outcomes were unaffected by race, minority groups had more minor postoperative complications than White patients, particularly UTI. Similar disparities were observed among PA cases. Higher rates of comorbidities may also have led to longer hospital stays. Further study is needed to understand what actions might be necessary to address any race-associated health disparities in ACF surgery.
To determine whether race predicts worse outcomes after ACF surgery.
A retrospective cohort study was performed using the American College of Surgeons National Surgical Quality Improvement Program data for 2005 to 2020. Current Procedural Terminology and International Classification of Diseases-9 codes were used to identify ACF tumor cases. Propensity score matching was performed to compare White and minority patients to assess the robustness of unmatched findings. A subanalysis of pituitary adenoma (PA) resections was also performed.
In an unmatched analysis of 1370 patients who underwent ACF surgery (67.9% White, 17.4% Black, 6.6% Asian/Pacific Islander, and 6.3% Hispanic), minority groups had higher rates of comorbidities. Unmatched multivariate analysis found Hispanic patients bore a 1.86 odds ratio (OR) of minor complications, Black and Asian and Pacific Islander patients bore 1.49 and 1.71 ORs, respectively, for extended length of stay, and Black patients bore a 3.78 OR for urinary tract infection (UTI). Matched analysis found that minority patients had higher UTI rates ( P = .02) and a 4.11 OR of UTI. In PA cases specifically, minority groups had higher comorbidities and length of stay in addition to extended length of stay odds (1.84 OR).
Although most ACF surgery outcomes were unaffected by race, minority groups had more minor postoperative complications than White patients, particularly UTI. Similar disparities were observed among PA cases. Higher rates of comorbidities may also have led to longer hospital stays. Further study is needed to understand what actions might be necessary to address any race-associated health disparities in ACF surgery.
摘要：
背景：基于种族的医疗保健结果仍有待前颅窝（ACF）手术描述。
目的：确定种族是否预示ACF手术后预后较差。
方法：使用美国外科医师学会国家外科质量改善计划2005年至2020年的数据进行了一项回顾性队列研究。使用当前程序术语和国际疾病分类-9代码来识别ACF肿瘤病例。进行倾向评分匹配以比较白人和少数民族患者，以评估未匹配发现的稳健性。还进行了垂体腺瘤（PA）切除术的亚分析。
结果：在对1370例接受ACF手术的患者进行的无与伦比的分析中（67.9％的白人，17.4%黑色,6.6%亚洲/太平洋岛民，和6.3%的西班牙裔），少数群体的合并症发生率较高。不匹配的多变量分析发现，西班牙裔患者的轻微并发症比值比（OR）为1.86，黑人和亚洲及太平洋岛民患者的ORs为1.49和1.71，分别,为了延长逗留时间，黑人患者的尿路感染（UTI）为3.78OR。匹配分析发现，少数患者的UTI发生率较高（P=.02），UTI的OR为4.11。特别是在PA案例中，除了延长住院时间的几率(1.84OR)外,少数群体的合并症和住院时间较高.
结论：尽管大多数ACF手术结果不受种族影响，少数群体比白人患者有更多的轻微术后并发症，尤其是UTI。在PA病例中观察到类似的差异。更高的合并症发生率也可能导致更长的住院时间。需要进一步研究以了解在ACF手术中可能需要采取哪些行动来解决与种族相关的健康差异。
目的：确定种族是否预示ACF手术后预后较差。
方法：使用美国外科医师学会国家外科质量改善计划2005年至2020年的数据进行了一项回顾性队列研究。使用当前程序术语和国际疾病分类-9代码来识别ACF肿瘤病例。进行倾向评分匹配以比较白人和少数民族患者，以评估未匹配发现的稳健性。还进行了垂体腺瘤（PA）切除术的亚分析。
结果：在对1370例接受ACF手术的患者进行的无与伦比的分析中（67.9％的白人，17.4%黑色,6.6%亚洲/太平洋岛民，和6.3%的西班牙裔），少数群体的合并症发生率较高。不匹配的多变量分析发现，西班牙裔患者的轻微并发症比值比（OR）为1.86，黑人和亚洲及太平洋岛民患者的ORs为1.49和1.71，分别,为了延长逗留时间，黑人患者的尿路感染（UTI）为3.78OR。匹配分析发现，少数患者的UTI发生率较高（P=.02），UTI的OR为4.11。特别是在PA案例中，除了延长住院时间的几率(1.84OR)外,少数群体的合并症和住院时间较高.
结论：尽管大多数ACF手术结果不受种族影响，少数群体比白人患者有更多的轻微术后并发症，尤其是UTI。在PA病例中观察到类似的差异。更高的合并症发生率也可能导致更长的住院时间。需要进一步研究以了解在ACF手术中可能需要采取哪些行动来解决与种族相关的健康差异。
