Medical Student John Sealy School of Medicine, Department of Neurosurgery, The University of Texas Medical Branch at Galveston Wylie, Texas, United States
Disclosure(s):
Adam Husain: No financial relationships to disclose
Introduction: Arteriovenous malformations (AVMs) are tangles of blood vessels involving abnormal connections between arteries and veins. Most AVMs are congenital and are susceptible to rupture resulting in hemorrhages with a high fatality rate. Pediatric AVMs are reported to carry a higher rate of rupture than AVMs in adults. The aim of this study is to identify socioeconomic and racial inequalities that must be addressed to improve post-procedural outcomes of pediatric patients with AVMs.
Methods: The Kids' Inpatient Database was analyzed and 1,017 pediatric patients diagnosed with cerebral AVMs were evaluated for patient mortality, number of diagnoses, and total charges based on factors such as race and income. Dependent variables were tested for significance using Yates's chi-squared test and multi-factor analysis of variance.
Results: Significant differences (p < 0.01) were found in patient mortality for patients belonging to the $50,000-$64,999 income quartile (4.35%) compared to patients belonging to the $86,000+ income quartile (0.403%) (p < 0.01). Black patients had significantly worse mortalities (5.1%) than White patients (2.2%) (p < 0.05). Interestingly, there were no significant differences in patient mortality in Hispanic patients compared to White patients (p>0.05). However, there was a significant difference in mortality rates between White patients (2.2%) and patients categorized as Other minorities (4.9%) (p < 0.05). Race also resulted in significant findings regarding number of diagnoses (p < 0.05) and total charges (p < 0.05).
Conclusion : The greater rate of patient mortality in lower income patients and Black patients highlights the impact that socioeconomic status and race can have on the outcomes of pediatric patients with AVMs. More research needs to be done to determine whether the cause of racial disparities is the result of differences in management and care of Black and White patients, hereditary factors prevalent in ethnic groups, or a combination of both.
