OBJECTIVE: The present study aims to determine if the racial representation of patients enrolled in a large prospective scoliosis registry is reflective of the general United States population. Further, we studied whether there was an association between race, pre-operative parameters, outcomes and loss to follow-up.
METHODS: Prospectively collected data for patients who underwent spinal fusion for adolescent idiopathic scoliosis (AIS) was reviewed, including self-reported race/ethnicity. The U.S. pediatric population and U.S. patients enrolled in the prospective registry were compared. The data obtained was analyzed for variations between races, for pre-operative variables and follow-up.
RESULTS: Of the 2210 included patients in the registry 66% of patients reported as White, while 52% of the 2018 U.S. pediatric population reported as White. 15% of the registry reported as Hispanic/Latino compared to 22% of the U.S. pediatric population, 13% Black compared to 14% of the U.S. pediatric population, and 4% Asian compared to 5% of the U.S. pediatric population. Asian and White patients had statistically significant higher 2-year follow-up in all but one of six enrollment sites (P < 0.001). Native American, Other, and Hispanic/Latino patients had the highest BMIs. Native American and Black patients had the highest pre-op thoracic Cobb angles. Pre-op ages of Black, Hispanic, and Native American patients were statistically lower (P < 0.01).
CONCLUSIONS: This study demonstrates the association between race and patient follow-up and pre-operative factors in patients who underwent surgery for AIS. Black, Native American, and Hispanic populations were underrepresented both at pre-op and follow-up when compared to their relative proportion in the U.S. pediatric population.
目的:本研究旨在确定在大型前瞻性脊柱侧凸登记中登记的患者的种族代表性是否反映了一般美国人群。Further,我们研究了种族之间是否有关联,术前参数,结果和随访损失。
方法:回顾性收集了青少年特发性脊柱侧凸(AIS)接受脊柱融合术的患者的数据,包括自我报告的种族/民族。比较了美国儿科人群和参加前瞻性注册的美国患者。对获得的数据进行了种族之间的差异分析,术前变量和随访。
结果:在注册的2210名患者中,66%的患者报告为白色,而2018年美国52%的儿科人口报告为白人。15%的注册报告为西班牙裔/拉丁裔,而美国儿科人口为22%,13%的黑人与14%的美国儿科人口相比,和4%的亚洲人相比,美国儿童人口的5%。在六个登记地点中,除一个以外,亚洲和白人患者的2年随访时间均具有统计学意义(P<0.001)。美洲原住民,Other,西班牙裔/拉丁裔患者的BMI最高。美洲原住民和黑人患者的术前胸廓Cobb角最高。黑人的术前年龄,西班牙裔,和美洲原住民患者在统计学上较低(P<0.01)。
结论:本研究证明了AIS手术患者的种族和患者随访与术前因素之间的关联。黑色,美洲原住民,与美国儿科人群中的相对比例相比,在术前和随访中,西班牙裔人群的比例均偏低.