Analyzing the Effects of Demographic Differences on Patient Outcomes Following Non-pyogenic Intracranial Venous Thrombosis.
Academic Article
Overview
abstract
OBJECTIVE: To investigate the effect of racial and demographic differences on the short-term outcome of patients following a non-pyogenic cerebral venous thrombosis. METHODS: Data from the National Inpatient Sample were gathered from the years 2013 to 2016. Patients who had a non-pyogenic cerebral venous thrombosis were identified. Admissions of patients between different racial groups were compared. Outcome measures included inpatient mortality, length of stay (LOS), all patients refined diagnosis-related group (APR-DRG) severity and mortality risk scores, non-routine discharges, total charges, sepsis, and urinary tract infections (UTIs). RESULTS: We identified 973 patients who were admitted with a non-pyogenic cerebral venous thrombosis between 2013 and 2016. Of those, 65.7% were classified as White, 15.6% as Black, 14.1% as Hispanic, and 4.6% as Asian or Pacific Islander. Compared to White patients, Black patients were found to have a higher severity score upon admission (2.94 ± 0.818 vs 2.77 ± 0.839; p = 0.025) as well as a longer adjusted LOS (8.085 ± 5.917 vs 6.503 ± 5.552; p = 0.004) and log LOS (0.934 ± 0.507 vs 0.773 ± 0.521; p = 0.001). On initial analysis, we found that older age, elevated WBC count, income group, anemia, and an expected primary payer of Medicare/Medicaid were significantly associated with Black race and also worse outcomes. When controlling for these variables using multivariate regression, older age, lower income group, and elevated WBC count were not significantly associated with any measures of outcome. The race was no longer associated with a higher APR-DRG severity score but was still significant for adjusted LOS (p = 0.001) and adjusted log LOS (p = 0.004). Lastly, we noted that anemia and the expected primary payer of Medicare/Medicaid were both independently and significantly associated with APR-DRG severity score (p = 0.003; p = 0.010) and the adjusted log LOS (p = 0.019; p = 0.035). CONCLUSIONS: Black patients admitted with a non-pyogenic intracranial venous thrombosis have significantly longer LOS compared to White patients. Anemia and Medicare/Medicaid as the primary expected payer also seem to play a role in longer LOS, as well as the severity of the case.
