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J Neurol Surg B Skull Base 2021; 82(06): 631-637
DOI: 10.1055/s-0040-1715590
Original Article

The Influence of Household Income on Survival following Posterior Fossa Tumor Resection at a Large Academic Medical Center

Rachel Blue
1   Department of Neurosurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
,
Donald K. Detchou
1   Department of Neurosurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
,
Ryan Dimentberg
1   Department of Neurosurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
,
Kaitlyn Shultz
2   Department of Mathematics, West Chester University of Pennsylvania, West Chester, Pennsylvania, United States
,
Michael Spadola
1   Department of Neurosurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
,
Scott D. McClintock
2   Department of Mathematics, West Chester University of Pennsylvania, West Chester, Pennsylvania, United States
,
Neil R. Malhotra
1   Department of Neurosurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
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Abstract

Objectives The present study examines the effect of median household income on mid- and long-term outcomes in a posterior fossa brain tumor resection population.

Design This is a retrospective regression analysis.

Setting The study conducted at a single, multihospital, urban academic medical center.

Participants A total of 283 consecutive posterior fossa brain tumor cases, excluding cerebellar pontine angle tumors, over a 6-year period (June 09, 2013–April 26, 2019) was included in this analysis.

Main Outcome Measures Outcomes studied included 90-day readmission, 90-day emergency department evaluation, 90-day return to surgery, reoperation within 90 days after index admission, reoperation throughout the entire follow-up period, mortality within 90 days, and mortality throughout the entire follow-up period. Univariate analysis was conducted for the whole population and between the lowest (Q1) and highest (Q4) socioeconomic quartiles. Stepwise regression was conducted to identify confounding variables.

Results Lower socioeconomic status was found to be correlated with increased mortality within 90 postoperative days and throughout the entire follow-up period. Similarly, analysis between the lowest and highest household income quartiles (Q1 vs. Q4) demonstrated Q4 to have significantly decreased mortality during total follow-up and a decreasing but not significant difference in 90-day mortality. No significant difference in morbidity was observed.

Conclusion This study suggests that lower household income is associated with increased mortality in both the 90-day window and total follow-up period. It is possible that there is an opportunity for health care providers to use socioeconomic status to proactively identify high-risk patients and provide additional resources in the postoperative setting.

Keywords

posterior fossa tumor - outcome disparities - socioeconomic status - readmissions


Publication History

Received: 28 February 2020

Accepted: 28 June 2020

Article published online:
12 October 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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