Association of Language Barriers With Process Outcomes After Craniotomy for Brain Tumor

Manuel, Solmaz P.; Chia, Zer Keen; Raygor, Kunal P.; Fernández, Alicia

doi:10.1227/neu.0000000000002080

Cited by 6 publications

(26 citation statements)

References 24 publications

(33 reference statements)

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“…After title and abstract review, 70 manuscripts were identified for full-text review. After full-text review, 29 studies met the inclusion criteria (eTable 2 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

“…All included studies were observational, and 26 of 29 studies were retrospective. All were cohort studies except for 1 cross-sectional study.…”

Section: Resultsmentioning

confidence: 99%

“…Studies reported findings from academic hospital settings and community hospitals. Eighteen of 29 studies were performed at a single center, whereas 5 studies were multicenter and 6 studies used a statewide or nationwide database (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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Association of Language Barriers With Perioperative and Surgical Outcomes

Joo,

Fernández,

Wick

et al. 2023

JAMA Netw Open

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ImportanceEnglish language proficiency has been reported to correlate with disparities in health outcomes. Therefore, it is important to identify and describe the association of language barriers with perioperative care and surgical outcomes to inform efforts aimed at reducing health care disparities.ObjectiveTo examine whether limited English proficiency compared with English proficiency in adult patients is associated with differences in perioperative care and surgical outcomes.Evidence ReviewA systematic review was conducted in MEDLINE, Embase, Web of Science, Sociological Abstracts, and CINAHL of all English-language publications from database inception to December 7, 2022. Searches included Medical Subject Headings terms related to language barriers, perioperative or surgical care, and perioperative outcomes. Studies that investigated adults in perioperative settings and involved quantitative data comparing cohorts with limited English proficiency and English proficiency were included. The quality of studies was evaluated using the Newcastle-Ottawa Scale. Because of heterogeneity in analysis and reported outcomes, data were not pooled for quantitative analysis. Results are reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols guideline.FindingsOf 2230 unique records identified, 29 were eligible for inclusion (281 266 total patients; mean [SD] age, 57.2 [10.0] years; 121 772 [43.3%] male and 159 240 [56.6%] female). Included studies were observational cohort studies, except for a single cross-sectional study. Median cohort size was 1763 (IQR, 266-7402), with a median limited English proficiency cohort size of 179 (IQR, 51-671). Six studies explored access to surgery, 4 assessed delays in surgical care, 14 assessed surgical admission length of stay, 4 assessed discharge disposition, 10 assessed mortality, 5 assessed postoperative complications, 9 assessed unplanned readmissions, 2 assessed pain management, and 3 assessed functional outcomes. Surgical patients with limited English proficiency were more likely to experience reduced access in 4 of 6 studies, delays in obtaining care in 3 of 4 studies, longer surgical admission length of stay in 6 of 14 studies, and more likely discharge to a skilled facility than patients with English proficiency in 3 of 4 studies. Some additional differences in associations were found between patients with limited English proficiency who spoke Spanish vs other languages. Mortality, postoperative complications, and unplanned readmissions had fewer significant associations with English proficiency status.Conclusions and RelevanceIn this systematic review, most of the included studies found associations between English proficiency and multiple perioperative process-of-care outcomes, but fewer associations were seen between English proficiency and clinical outcomes. Because of limitations of the existing research, including study heterogeneity and residual confounding, mediators of the observed associations remain unclear. Standardized reporting and higher-quality studies are needed to understand the impact of language barriers on perioperative health disparities and identify opportunities to reduce related perioperative health care disparities.

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“…After title and abstract review, 70 manuscripts were identified for full-text review. After full-text review, 29 studies met the inclusion criteria (eTable 2 in Supplement 1).…”

Section: Resultsmentioning

confidence: 99%

“…All included studies were observational, and 26 of 29 studies were retrospective. All were cohort studies except for 1 cross-sectional study.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Association of Language Barriers With Perioperative and Surgical Outcomes

Joo,

Fernández,

Wick

et al. 2023

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

show abstract

“…While the adverse effect of language barriers on patient care has been explored in other pathologies, the authors here examine this effect on patients undergoing craniotomy for tumor resection at their institution. 1 Their results indicated that limited English proficiency was associated with extended length of stay, increased cost of hospitalization, and increased likelihood of discharge to a skilled care facility after surgery. These findings are consistent with previously reported outcomes for hospitalized patients with lower English proficiency.…”

mentioning

confidence: 99%

“…The authors here have investigated how a barrier between patients and their providers affects the hospital course for patients undergoing craniotomy for brain tumors at their institution. 1…”

mentioning

confidence: 99%