Racial and gender disparities and the role of primary tumor type on inpatient outcomes following craniotomy for brain metastases

Miriam A Nuno, Debraj Mukherjee, Adam Elramsisy, Kristin Nosova, Shivanand P. Lad, Maxwell Boakye, John S. Yu, Keith L. Black, Chirag G. Patil

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Race and gender disparities in outcomes have been documented in many cancers. Our study evaluated the role of race, gender, and tumor primary site in predicting in-hospital mortality, discharge disposition, and complications among patients with brain metastases. Methods: Using Nationwide Inpatient Sample (NIS) data from 1998 to 2007, we evaluated in-patient outcomes of brain metastases patients who underwent a craniotomy in U.S. hospitals. Univariate and multivariate analyses were used to assess the effect of patient/tumor characteristics in predicting the proposed outcomes. Results: NIS estimated 78,170 patients with metastatic brain tumors underwent craniotomy between 1998 and 2007 in the United States. Median age was 59.2 years, 52.1 % were women, and 6.4 % were black. In-hospital mortality rate was 2.2 % with an average length of stay of 7.6 days. Black patients had significantly higher morbidity and nonroutine discharges than whites/others (p < .0001). Black women had almost twice the mortality (3.4 vs 1.8 %, p < .0001), a higher complication rate (24.6 vs 18.8 %, p < .0001), longer hospital stays (10.0 vs 7.3 days, p < .0001), and more nonroutine discharges (45.1 vs 36.8 %, p < .0001), compared with white/other women. Tumor histology was a significant predictor of outcomes, with female lung cancer patients having the highest odds of mortality and primary gastrointestinal tumors having the highest number of complications. Conclusions: Evidence of race and gender disparities in outcomes were found in black patients, especially in black females who underwent surgical resection for brain metastases. These findings highlight an opportunity to reduce the gap of outcome disparities in brain metastasis patients.

Original languageEnglish (US)
Pages (from-to)2657-2663
Number of pages7
JournalAnnals of Surgical Oncology
Volume19
Issue number8
DOIs
StatePublished - Aug 1 2012
Externally publishedYes

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Craniotomy
Inpatients
Neoplasm Metastasis
Brain
Neoplasms
Hospital Mortality
Mortality
Length of Stay
Brain Neoplasms
Lung Neoplasms
Histology
Multivariate Analysis
Morbidity

ASJC Scopus subject areas

  • Surgery
  • Oncology

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Racial and gender disparities and the role of primary tumor type on inpatient outcomes following craniotomy for brain metastases. / Nuno, Miriam A; Mukherjee, Debraj; Elramsisy, Adam; Nosova, Kristin; Lad, Shivanand P.; Boakye, Maxwell; Yu, John S.; Black, Keith L.; Patil, Chirag G.

In: Annals of Surgical Oncology, Vol. 19, No. 8, 01.08.2012, p. 2657-2663.

Research output: Contribution to journalArticle

Nuno, Miriam A ; Mukherjee, Debraj ; Elramsisy, Adam ; Nosova, Kristin ; Lad, Shivanand P. ; Boakye, Maxwell ; Yu, John S. ; Black, Keith L. ; Patil, Chirag G. / Racial and gender disparities and the role of primary tumor type on inpatient outcomes following craniotomy for brain metastases. In: Annals of Surgical Oncology. 2012 ; Vol. 19, No. 8. pp. 2657-2663.
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abstract = "Background: Race and gender disparities in outcomes have been documented in many cancers. Our study evaluated the role of race, gender, and tumor primary site in predicting in-hospital mortality, discharge disposition, and complications among patients with brain metastases. Methods: Using Nationwide Inpatient Sample (NIS) data from 1998 to 2007, we evaluated in-patient outcomes of brain metastases patients who underwent a craniotomy in U.S. hospitals. Univariate and multivariate analyses were used to assess the effect of patient/tumor characteristics in predicting the proposed outcomes. Results: NIS estimated 78,170 patients with metastatic brain tumors underwent craniotomy between 1998 and 2007 in the United States. Median age was 59.2 years, 52.1 {\%} were women, and 6.4 {\%} were black. In-hospital mortality rate was 2.2 {\%} with an average length of stay of 7.6 days. Black patients had significantly higher morbidity and nonroutine discharges than whites/others (p < .0001). Black women had almost twice the mortality (3.4 vs 1.8 {\%}, p < .0001), a higher complication rate (24.6 vs 18.8 {\%}, p < .0001), longer hospital stays (10.0 vs 7.3 days, p < .0001), and more nonroutine discharges (45.1 vs 36.8 {\%}, p < .0001), compared with white/other women. Tumor histology was a significant predictor of outcomes, with female lung cancer patients having the highest odds of mortality and primary gastrointestinal tumors having the highest number of complications. Conclusions: Evidence of race and gender disparities in outcomes were found in black patients, especially in black females who underwent surgical resection for brain metastases. These findings highlight an opportunity to reduce the gap of outcome disparities in brain metastasis patients.",
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T1 - Racial and gender disparities and the role of primary tumor type on inpatient outcomes following craniotomy for brain metastases

AU - Nuno, Miriam A

AU - Mukherjee, Debraj

AU - Elramsisy, Adam

AU - Nosova, Kristin

AU - Lad, Shivanand P.

AU - Boakye, Maxwell

AU - Yu, John S.

AU - Black, Keith L.

AU - Patil, Chirag G.

PY - 2012/8/1

Y1 - 2012/8/1

N2 - Background: Race and gender disparities in outcomes have been documented in many cancers. Our study evaluated the role of race, gender, and tumor primary site in predicting in-hospital mortality, discharge disposition, and complications among patients with brain metastases. Methods: Using Nationwide Inpatient Sample (NIS) data from 1998 to 2007, we evaluated in-patient outcomes of brain metastases patients who underwent a craniotomy in U.S. hospitals. Univariate and multivariate analyses were used to assess the effect of patient/tumor characteristics in predicting the proposed outcomes. Results: NIS estimated 78,170 patients with metastatic brain tumors underwent craniotomy between 1998 and 2007 in the United States. Median age was 59.2 years, 52.1 % were women, and 6.4 % were black. In-hospital mortality rate was 2.2 % with an average length of stay of 7.6 days. Black patients had significantly higher morbidity and nonroutine discharges than whites/others (p < .0001). Black women had almost twice the mortality (3.4 vs 1.8 %, p < .0001), a higher complication rate (24.6 vs 18.8 %, p < .0001), longer hospital stays (10.0 vs 7.3 days, p < .0001), and more nonroutine discharges (45.1 vs 36.8 %, p < .0001), compared with white/other women. Tumor histology was a significant predictor of outcomes, with female lung cancer patients having the highest odds of mortality and primary gastrointestinal tumors having the highest number of complications. Conclusions: Evidence of race and gender disparities in outcomes were found in black patients, especially in black females who underwent surgical resection for brain metastases. These findings highlight an opportunity to reduce the gap of outcome disparities in brain metastasis patients.

AB - Background: Race and gender disparities in outcomes have been documented in many cancers. Our study evaluated the role of race, gender, and tumor primary site in predicting in-hospital mortality, discharge disposition, and complications among patients with brain metastases. Methods: Using Nationwide Inpatient Sample (NIS) data from 1998 to 2007, we evaluated in-patient outcomes of brain metastases patients who underwent a craniotomy in U.S. hospitals. Univariate and multivariate analyses were used to assess the effect of patient/tumor characteristics in predicting the proposed outcomes. Results: NIS estimated 78,170 patients with metastatic brain tumors underwent craniotomy between 1998 and 2007 in the United States. Median age was 59.2 years, 52.1 % were women, and 6.4 % were black. In-hospital mortality rate was 2.2 % with an average length of stay of 7.6 days. Black patients had significantly higher morbidity and nonroutine discharges than whites/others (p < .0001). Black women had almost twice the mortality (3.4 vs 1.8 %, p < .0001), a higher complication rate (24.6 vs 18.8 %, p < .0001), longer hospital stays (10.0 vs 7.3 days, p < .0001), and more nonroutine discharges (45.1 vs 36.8 %, p < .0001), compared with white/other women. Tumor histology was a significant predictor of outcomes, with female lung cancer patients having the highest odds of mortality and primary gastrointestinal tumors having the highest number of complications. Conclusions: Evidence of race and gender disparities in outcomes were found in black patients, especially in black females who underwent surgical resection for brain metastases. These findings highlight an opportunity to reduce the gap of outcome disparities in brain metastasis patients.

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DO - 10.1245/s10434-012-2353-z

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JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

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