Table 3 –
Procedure Utilization and Inpatient Safety Measures for Propensity Score Matched Populations: White vs. Black and White vs. Hispanic
| White (n=2158) | Black (n=2158) | Odd Ratio or Difference [95% CI] |
p value1 | |
|---|---|---|---|---|
| Fusion Utilization | 0.45 | |||
| PLF2 | 724 (33.5%) | 734 (34%) | 1.02 [0.90, 1.16] | |
| P/TLIF only2 | 797 (36.9%) | 791 (36.7%) | 0.99 [0.87, 1.12] | |
| ALIF only2 | 140 (6.5%) | 121 (5.6%) | 0.86 [0.67, 1.10] | |
| PLF + P/TLIF2 | 342 (15.8%) | 373 (17.3%) | 1.11 [0.94, 1.30] | |
| Anterior-posterior fusion2 | 155 (7.2%) | 139 (6.4%) | 0.89 [0.70, 1.13] | |
| LOS (days)* | 3 (2–5) | 3 (3–5) | 0 [0, 0] | <0.0001 |
| Cost (US dollars)*3 | 27526 (19665–39617) | 29121 (21150–40756) | 1643 [870, 2383] | 0.004 |
| Prolonged LOS4 | 305 (14.13%) | 390 (18.07%) | 1.34 [1.14, 1.58] | 0.0004 |
| Inpatient Medical Complications | 169 (7.83%) | 214 (9.92%) | 1.30 [1.05, 1.60] | 0.016 |
| Inpatient Surgical Complications | 109 (5.05%) | 114 (5.28%) | 1.05 [0.80, 1.37] | 0.73 |
| Mortality | 3 (0.14%) | 5 (0.23%) | 1.67 [0.40, 6.99] | 0.51 |
| White (n=1310) | Hispanic (n=1310) | Odd Ratio or Difference [95% CI] |
p value1 | |
| Fusion Utilization | 0.38 | |||
| PLF2 | 420 (32.1%) | 428 (32.7%) | 1.03 [0.87, 1.21] | |
| P/TLIF only2 | 502 (38.3%) | 476 (36.3%) | 0.92 [0.78, 1.08] | |
| ALIF only2 | 91 (6.9%) | 80 (6.1%) | 0.87 [0.64, 1.19] | |
| PLF + P/TLIF2 | 177 (13.5%) | 209 (16%) | 1.22 [0.98, 1.51] | |
| Anterior-posterior fusion2 | 120 (9.2%) | 117 (8.9%) | 0.97 [0.74, 1.27] | |
| LOS (days)* | 3 (2–4) | 3 (2–5) | 0 [0, 0] | 0.002 |
| Cost (US dollars)*3 | 29677 (20606–42699) | 31340 (22221–45054) | 1698 [649, 2711] | 0.005 |
| Prolonged LOS4 | 156 (11.91%) | 191 (14.58%) | 1.26 [1.01, 1.58] | 0.044 |
| Inpatient Medical Complications | 104 (7.94%) | 115 (8.78%) | 1.12 [0.85, 1.47] | 0.44 |
| Inpatient Surgical Complications | 77 (5.88%) | 92 (7.02%) | 1.21 [0.88, 1.65] | 0.23 |
| Mortality | 1 (0.08%) | 2 (0.15%) | 2.00 [0.18, 22.13] | 0.62 |
Data reported as median (Q1–Q3)
Wilcoxon signed-rank test was performed for LOS and cost; Chi-squared test was performed for prolonged LOS, inpatient medical complications, and inpatient surgical complications; Fisher’s exact test was performed for mortality.
PLF indicates posterolateral fusion, P/TLIF indicates posterior or transforaminal lumbar interbody fusion, ALIF indicates anterior lumbar interbody fusion (also includes extreme lateral interbody fusion, XLIF, and direct lateral interbody fusion, DLIF), and anterior-posterior fusion indicates a combined PLF + ALIF procedure.
Total admission cost: Total charges for each hospital discharge were converted to total cost using hospital-specific cost-to-charge ratios, which are based on hospital accounting reports collected by the Centers for Medicare & Medicaid Services.
Prolonged LOS is defined as a hospital length of stay greater than the 90th percentile for the fusion procedure performed.