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
