Postdoctoral Research Fellow University of Wisconsin-Madison
Introduction: Pituitary tumors are among the most common intracranial malignancies. We intend to investigate the relationship between race, ethnicity, socioeconomic status, hospital volume and pituitary surgery outcomes.
Methods: This is a retrospective cross-sectional study of the NIS between 2010 and 2020. The demographics, hospital characteristics, postoperative complications, and in-hospital mortality of white, black, and Hispanic patients undergoing pituitary surgery were compared
Results: There were 94,246 patients of white, black, or Hispanic race who had pituitary surgery.There were 60292 white patients (64%), 19,601black patients (21%), and 14,353 Hispanic patients (15%). Hispanic patients were younger (mean age, 50.4 years) and female (53.94%) than white or black patients(p < 0.0001). Patients of the black and Hispanic races were more likely to live in low-income zip codes (40.7% and 32.3%, respectively) than white patients (19.3%), and were more likely to have Medicaid insurance (14% and 21%, respectively) than white patients (7%). Southern (36%, 56%, and 37%, respectively) and teaching hospitals (90%, 92%, and 88%, respectively) had the highest representation across all racial groups.Blacks and Hispanics had a higher odds of mortality, developing any postoperative complications (2.48, 2.16, p=0.001, 0.006), diabetes insipidus (1.18, 1.21, p=0.001), fluid and electrolyte disorder(1.36, 1.18, p=0.001, 0.006) than white patients. Hispanics had a higher odds of developing csf leak than white(1.24, p=0.006).Black had a higher odds of developing pulmonary, renal and hemorrhage complications than white (1.34, 2.62,1.48, p=0.018,0.001, 0.02).Medicaid insurance was associated with a higher likelihood of developing any complications, csf leak, diabetes insipidus, fluid and electrolyte disorder, cardiac, while private insurance was associated with a higher likelihood of developing mortality, any complications, cns infection, diabetes insipidus, fluid and electrolyte disorder, pulmonary, cardiac, renal and hemorrhage in comparison to Medicare insurance.
Conclusion : This study demonstrates significant racial and socioeconomic disparities influence the admission, postoperative complications, and mortality of surgery for patients with pituitary tumors.
