• Rijul Nanda, Khaled M Taghlabi, Isuru Somawardana, Lokeshwar S Bhenderu, Jaime R Guerrero, Aboud Tahanis, Jesus G Cruz-Garza, and Amir H Faraji.
• Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas; Texas A&M University School of Engineering Medicine, Houston, Texas; Clinical Innovations Laboratory, Houston Methodist Research Institute, Houston, Texas. Electronic address: rijulnanda@tamu.edu.
• World Neurosurg. 2024 May 4.

ObjectiveThis study aims to assess race as an independent risk factor for postoperative complications after surgical fixation of traumatic thoracolumbar fractures for African American and Asian American patients compared with white patients.MethodsThe 2011-2021 American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) dataset was used to identify patients undergoing fusion surgeries for thoracolumbar spine fractures. Patient comorbidity burden was assessed using a modified 5-item frailty index score (mFI-5). Chi-squared and ANOVA tests were used to compare baseline clinical characteristics between groups. Multivariate analysis was performed to compare African American and Asian American patients with white patients controlling for age, BMI, and American Society of Anesthesiologists (ASA) score.ResultsAfrican American patients experienced longer operative times compared to Asian American and white patients (3.74 ± 1.87 hours versus 3.04 ± 1.71 hours and 3.48 ± 1.81 hours, p<0.001). African American and Asian American patients demonstrated higher comorbidity burden with mFI-5>2 compared to white patients (30.7 % and 25.6% versus 19.9%, p<0.001). African American and Asian American patients had a higher risk of postoperative complications than white patients (22.4% and 20% versus 19.7%, p<0.001). African American race was an independent risk factor of postoperative 30-day morbidity (OR 1.19, CI 1.11 - 1.28, p<0.001).ConclusionsAfrican American and Asian American patients undergoing thoracolumbar fusion surgeries exhibit disproportionate comorbidity burden, longer LOS, and greater postoperative complications compared with white patients. Furthermore, the African American race was associated with an increased rate of 30-day postoperative complications.Copyright © 2024. Published by Elsevier Inc.

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