Orthopedics Commons^™

Socioeconomic Disparities Exist In Access To Rotator Cuff Repair Surgery, Justin Solarczyk, Heather Roberts Md, Stephanie Wong Md, Derek Ward Md

Journal of Health Disparities Research and Practice

Background: The relationship of socioeconomic disparity in access to rotator cuff repair (RCR) has not been well studied. Socioeconomic, racial, and ethnic disparities in access to surgical management of rotator cuff tears have previously been described in patients with commercial insurance. This study is a population-level analysis which investigates racial and ethnic disparities in access to surgical rotator cuff repair across multiple health insurance statuses.

Purpose: (1) Is non-white race and ethnicity associated with lower rates of RCR? (2) Do these associations change throughout different insurance statuses?

Methods: We used the Healthcare Cost and Utilization Project (HCUP) database to identify …

The Role Of Socioeconomic Status, Race, And Gender In Patient-Reported Outcomes Following Total Hip Arthroplasty, Allyn M. Bove, James Porter, Aatif Sayeed, Clair Smith, Brian A. Klatt

Journal of Health Disparities Research and Practice

Background

Disparities in total joint arthroplasty are well-documented. However, much of the research regarding disparities in vulnerable populations receiving total hip arthroplasty (THA) have focused on short-term outcomes. The purpose of this study was to examine the effects of race, gender, and socioeconomic status (SES) on patient-reported outcomes six months following THA.

Methods

Electronic health record data were retrospectively analyzed for 269 individuals who underwent THA at a large urban hospital from 2013-16. Data retrieved included patient demographics, baseline health information, data regarding hospital length of stay when undergoing THA, post-operative complications, and patient-reported function, measured by the Harris Hip …

Prevalence Trend And Disparities In Rheumatoid Arthritis Among Us Adults, 2005–2018, Yingke Xu, Qing Wu

Public Health Faculty Publications

Rheumatoid arthritis (RA) trends among US adults and disparities in RA patients in recent years have not been well described. We aimed to examine the trend of RA prevalence and disparities among US adults. Data from the National Health and Nutrition Examination Survey (NHANES) of the years 2005–2018 were analyzed to examine the self-reported RA prevalence trend. Age-adjusted RA prevalence stratified by race/ethnicity and socioeconomic status (SES), as well as associated linear trends, were calculated for both genders. The multivariable adjustment was used to evaluate the association between race, SES, and RA. During 2005–2018, there was no significant linear trend …

Functional Outcomes Of Unstable Ankle Fractures With And Without Syndesmotic Fixation In The Adolescent Population, Connor J. Paez, Benjamin M. Lurie, Vidyadhar V. Upasani, Andrew T. Pennock

School of Medicine Faculty Publications

Purpose: The purpose of this study was to compare functional outcomes of adolescents with and without ankle syndesmotic injuries and identify predictors of functional outcome after operative ankle fractures. Methods: A retrospective review was conducted on operative adolescent ankle fractures treated between 2009 and 2019 with a minimum of one-year follow-up (mean 4.35 years). Patients who underwent syndesmotic fixation (SF) (n = 48) were compared with operative ankle fractures without syndesmotic injury (n = 63). Functional outcomes were assessed using standardized questionnaires, specifically the Foot and Ankle Ability Measure (FAAM) and Single Assessment Numerical Evaluation. Results: There were no differences …

Patterns Of Lumbar Disc Degeneration: Magnetic Resonance Imaging Analysis In Symptomatic Subjects, Monchai Ruangchainikom, Michael D. Daubs, Akinobu Suzuki, Chengjie Xiong, Tetsuo Hayashi, Trevor P. Scott, Kevin Phan, Jeffrey C. Wang

School of Medicine Faculty Publications

Study Design: Cross-sectional study. Purpose: To evaluate lumbar disc degeneration (LDD) on magnetic resonance imaging (MRI) in symptomatic subjects to accumulate baseline data on the pattern of degeneration. Overview of Literature: LDD plays an important role in the diagnosis and treatment of low-back pain in patients. Few studies have focused on the pattern of LDD to understand how the lumbar spine ages. Methods: This study included 1,095 patients (mean age, 44.29 years; range, 16–85 years) who underwent upright lumbar MRI. LDD was graded into five categories (I–V). Positive LDD was defined as grade III or greater. The prevalence and pattern …

Evaluating The Performance Of The Who International Reference Standard For Osteoporosis Diagnosis In Postmenopausal Women Of Varied Polygenic Score And Race, Qing Wu, Xiangxue Xiao, Yingke Xu

School of Medicine Faculty Publications

Background: Whether the bone mineral density (BMD) T-score performs differently in osteoporosis classification in women of different genetic profiling and race background remains unclear. Methods: The genomic data in the Women’s Health Initiative study was analyzed (n = 2417). The polygenic score (PGS) was calculated from 63 BMD-associated single nucleotide polymorphisms (SNPs) for each participant. The World Health Organization′s (WHO) definition of osteoporosis (BMD T-score ≤ −2.5) was used to estimate the cumulative incidence of fracture. Results: T-score classification significantly underestimated the risk of major osteoporotic fracture (MOF) in the WHI study. An enormous underestimation was observed in African American …

Health Literacy And Patient Reported Outcomes In Orthopaedic Surgery Patients, Thiran Udawatta, Lance Flesch, Michael Eng, Jane E. Oliphant, Scott G. Kaar

Journal of Health Disparities Research and Practice

Background: Health literacy may be an important factor in patient health outcomes, however, prior research has primarily focused on primary care patients with research in orthopaedic specific populations lacking.

Questions/purposes: The purpose of this study was to examine the relationship between health literacy and patient reported outcomes in an orthopaedic patient population.

Patients and Methods: 183 patients >18 years of age who presented to our institution’s sports orthopaedic surgery clinic with shoulder or knee complaints were analyzed. The primary outcomes were physical function recorded using Patient-Reported Outcomes Measurement Information System (PROMIS) physical function and Single Assessment Numerical Evaluation (SANE) scores. …

Preoperative Maximization To Reduce Complications In Spinal Surgery, Sukanta Maitra, Christopher Mikhail, Samuel K. Cho, Michael D. Daubs

School of Medicine Faculty Publications

Study design: Invited narrative review. Objectives: The aim of this review was to summarize current literature regarding risk factors that surgeons can optimize in the preoperative setting in the spinal surgery patient, in order to reduce complications and improve patient-reported outcomes. Methods: Review of the relevant literature by the authors. Results: Modifiable risk factors identified relative to the patient include obesity, malnutrition/nutrient deficiency, diabetes/hyperglycemia, preoperative anemia, vitamin D/DEXA (dual-energy radiograph absorptiometry), nicotine use/smoking, and opioid use/psychosocial factors. Conclusion: By maximizing a patient's physiological and psychological status prior to elective spine surgery, we may move closer to achieving the goals of …

Population-Based Survey Of Lumbar Surgery Beliefs In The United States, Amanda Elyse Mccauley, Zachery Clark Rasmussen

UNLV Theses, Dissertations, Professional Papers, and Capstones

Purpose/Hypothesis: Studies have shown that poor lumbar surgery outcomes may be influenced by a person’s preconceived perceptions of low back surgery (LBS). However, the perceptions of the general population about issues related to lumbar surgery are not known. Therefore, the purpose of this study was to investigate the general population’s perceptions regarding LBS.

Number of Subjects: This study included 262 participants (Average age: 46.1, SD=16.9; 125 Males, 137 Females) who completed the questionnaire from the general population in the Las Vegas area.

Materials/Methods: Questionnaire development involved expert panel feedback from three physical therapists, three spine surgeons, two surgeon assistants/nurses, two …