Access to early surgery may differ among patients with traumatic spinal cord injuries
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CHICAGO — Results presented at the North American Spine Society Annual Meeting showed access to early surgery may not be equal among patients with traumatic spinal cord injuries.
“Our results raise concerns with regard to ethical access to care based on race and age,” Ali Moghaddamjou, MD, said in his presentation here. “The results also highlight the importance of limiting hospital transfers.”
Using the Surgical Timing in Acute Spinal Cord Injury Study and the North American Clinical Trials Network dataset, Moghaddamjou and colleagues classified patients with traumatic spinal cord injury into groups based on whether they underwent either early surgery or delayed surgery.
“We identified early surgery using the 24-hour cutoff,” Moghaddamjou said. “The 24-hour cutoff is what is most often cited in the literature and has the greatest amount of evidence.”
Among the 580 patients included in the study, Moghaddamjou noted 38% received early surgery. Patients who underwent early surgery were sicker and had more severe injuries, with a baseline injury severity score of 8 in 48% of patients who underwent early surgery compared with 31% of patients who had late surgery, according to Moghaddamjou.
“Furthermore, 69% of the patients who got early surgery had survivable injuries compared to 59% of the patients who had late surgery,” Moghaddamjou said.
The mixed-effects model showed an association between white race and undergoing early surgery.
“Factors associated with delay of surgery were patients who were transferred to the treatment hospital and patients who generally had more severe injuries as presented by lower baseline lower extremity motor score,” Moghaddamjou said.
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Moghaddamjou A, et al. Paper 103. Presented at: North American Spine Society Annual Meeting; Oct. 12-15, 2022; Chicago.
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