Gender disparities in clinical presentation, treatment, and outcomes in metastatic spine disease

Price, Meghan; Goodwin, Jessica; Ramos, Rafael De la Garza; Baëta, César; Dalton, Tara; McCray, Edwin; Yassari, Reza; Karikari, Isaac O.; Abd-El-Barr, Muhammad M.; Goodwin, Andrea N.; Goodwin, C. Rory

doi:10.1016/j.canep.2020.101856

Cited by 9 publications

(8 citation statements)

References 49 publications

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“…Few papers report the incidence of MESCC and motor deficit separately. Interestingly, they all demonstrate that approximately one third of MESCC patients have an actual neurological deficit (31% MESCC and 11% paresis [22] , 36.2% MESCC and 9.5% paresis [19] , 27.7% MESCC and 12,5% unable to walk [33] , 45 patients with MESCC and 15 unable to walk 49 ).…”

Section: Resultsmentioning

confidence: 99%

“…Remarkably, none of them reports the actual definition used for MESCC or pVCF. Whereas some studies use diagnostic codes in databases [14] , [15] , [16] , [17] , [18] , [19] , [20] , such codes refer to registrations, while being non-informative with regard to grade or severity of MESCC or pVCF. Thirty-six studies are retrospective, thus increasing the risk of bias.…”

Section: Resultsmentioning

confidence: 99%

“…Zaikova et al report an annual incidence of 8.1 per 100.000 inhabitants [22] . The cumulative incidence of MESCC in patients with SM, ranges from 3.41% to 36.20% (mean 19.53%, 95% CI: -6.85%-45.91%) [15] , [19] , [22] , [24] .…”

Section: Resultsmentioning

confidence: 99%

“…In patients with SM, the cumulative incidence of pVCF ranges from 5.30%-74.50% (mean 25.44%, 95% CI: -26.78%-77.66%) [15] , [19] , [24] , [50] . Price et al report a significantly higher incidence of 74.50% and a significant gender difference with females having an even higher incidence (81.5%) compared to males (68.0%, p<0.001), attributed to an increased prevalence of osteoporosis in female, they do comment the significantly higher incidence of pVCF overall [19] . Two papers report incidences of pVCF in patients with solid tumors, the cumulative incidence ranging from 0.41%-0.93% [15] , [24] .…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review

Brande

Cornips

Peeters

et al. 2022

Journal of Bone Oncology

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review

Brande

Cornips

Peeters

et al. 2022

Journal of Bone Oncology

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“…[16][17][18][19][20] Numerous studies have demonstrated that neurological presentation, systemic burden of disease, and demographic factors, including age at admission, are factors in determining prognosis and clinical outcomes. [21][22][23][24] However, no study has examined the relationship between transfer status and outcomes specifically in patients with MSD.…”

mentioning

confidence: 99%

Interhospital transfer status for spinal metastasis patients in the United States is associated with more severe clinical presentations and higher rates of inpatient complications

Ramos

Park²,

McCray³

et al. 2021

Neurosurgical Focus

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OBJECTIVE In patients with metastatic spinal disease (MSD), interhospital transfer can potentially impact clinical outcomes as the possible benefits of transferring a patient to a higher level of care must be weighed against the negative effects associated with potential delays in treatment. While the association of clinical outcomes and transfer status has been examined in other specialties, the relationship between transfer status, complications, and risk of mortality in patients with MSD has yet to be explored. The purpose of this study was to examine the impact of transfer status on in-hospital mortality and clinical outcomes in patients diagnosed with MSD. METHODS The National (Nationwide) Inpatient Sample (NIS) database was retrospectively queried for adult patients diagnosed with vertebral pathological fracture and/or spinal cord compression in the setting of metastatic disease between 2012 and 2014. Demographics, baseline characteristics (e.g., metastatic spinal cord compression [MSCC] and paralysis), comorbidities, type of intervention, and relevant patient outcomes were controlled in a multivariable logistic regression model to analyze the association of transfer status with patient outcomes. RESULTS Within the 10,360 patients meeting the inclusion and exclusion criteria, higher rates of MSCC (50.2% vs 35.9%, p < 0.001) and paralysis (17.3% vs 8.4%, p < 0.001) were observed in patients transferred between hospitals compared to those directly admitted. In univariable analysis, a higher percentage of transferred patients underwent surgical intervention (p < 0.001) when compared with directly admitted patients. After controlling for significant covariates and surgical intervention, transferred patients were more likely to develop in-hospital complications (OR 1.34, 95% CI 1.18–1.52, p < 0.001), experience prolonged length of stay (OR 1.33, 95% CI 1.16–1.52, p < 0.001), and have a discharge disposition other than home (OR 1.70, 95% CI 1.46–1.98, p < 0.001), with no significant difference in inpatient mortality rates. CONCLUSIONS Patients with MSD who were transferred between hospitals demonstrated more severe clinical presentations and higher rates of inpatient complications compared to directly admitted patients, despite demonstrating no difference in in-hospital mortality rates.

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Analysis of socioeconomic and demographic factors on post-treatment outcomes for metastatic spinal tumors

Larkin

Thirunavu

Nahi

et al. 2023

Clinical Neurology and Neurosurgery

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Gender disparities in clinical presentation, treatment, and outcomes in metastatic spine disease

Cited by 9 publications

References 49 publications

Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review

Epidemiology of spinal metastases, metastatic epidural spinal cord compression and pathologic vertebral compression fractures in patients with solid tumors: A systematic review

Interhospital transfer status for spinal metastasis patients in the United States is associated with more severe clinical presentations and higher rates of inpatient complications

Analysis of socioeconomic and demographic factors on post-treatment outcomes for metastatic spinal tumors

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