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. 2022 Jul 31;10(1):62-70.
doi: 10.1093/nop/npac061. eCollection 2023 Feb.

Racial disparities in inpatient clinical presentation, treatment, and outcomes in brain metastasis

Edwin McCray  1 , Romaric Waguia  1 , Rafael de la Garza Ramos  2 , Meghan J Price  1 , Theresa Williamson  3 , Tara Dalton  1 , Daniel M Sciubba  4 , Reza Yassari  2 , Andrea N Goodwin  5 , Peter Fecci  1 , Margaret O Johnson  6 , Kaisorn Chaichana  7 , C Rory Goodwin  1
Affiliations

Racial disparities in inpatient clinical presentation, treatment, and outcomes in brain metastasis

Edwin McCray et al. Neurooncol Pract. .

Abstract

Background: Few studies have assessed the impact of race on short-term patient outcomes in the brain metastasis population. The goal of this study is to evaluate the association of race with inpatient clinical presentation, treatment, in-hospital complications, and in-hospital mortality rates for patients with brain metastases (BM).

Method: Using data collected from the National Inpatient Sample between 2004 and 2014, we retrospectively identified adult patients with a primary diagnosis of BM. Outcomes included nonroutine discharge, prolonged length of stay (pLOS), in-hospital complications, and mortality.

Results: Minority (Black, Hispanic/other) patients were less likely to receive surgical intervention compared to White patients (odds ratio [OR] 0.70; 95% confidence interval [CI] 0.66-0.74, p < 0.001; OR 0.88; 95% CI 0.84-0.93, p < 0.001). Black patients were more likely to develop an in-hospital complication than White patients (OR 1.35, 95% CI 1.28-1.41, p < 0.001). Additionally, minority patients were more likely to experience pLOS than White patients (OR 1.48; 95% CI 1.41-1.57, p < 0.001; OR 1.34; 95% CI 1.27-1.42, p < 0.001). Black patients were more likely to experience a nonroutine discharge (OR 1.25; 95% CI 1.19-1.31, p < 0.001) and higher in-hospital mortality than White (OR 1.13; 95% CI 1.03-1.23, p = 0.008).

Conclusion: Our analysis demonstrated that race is associated with disparate short-term outcomes in patients with BM. More efforts are needed to address these disparities, provide equitable care, and allow for similar outcomes regardless of care.

Keywords: brain metastases; clinical outcomes; disparities; inpatient; race.

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Figures

Figure 1.
Figure 1.
Differences in rates of postoperative complications by race. * indicates p > 0.01; ** indicates p < 0.001.
Figure 2.
Figure 2.
Differences in rates of complications by race. ** indicates p < 0.001.
Figure 3.
Figure 3.
Differences in rates of intervention (surgery, radiotherapy, or chemotherapy) by race. ** indicates p < 0.001.
See this image and copyright information in PMC

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