Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2023
The Impact of Social Determinants of Health on Vestibular Schwannoma Management: A Single Institution Review.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Ellsperman Susan E, Bellile Emily, Fryatt Rachel, Hoi Karen, Wang JiCi, Fayson Shannon, Banakis Hartl Renee M, Stucken Emily Z
Аннотация
OBJECTIVE: To evaluate social determinants of health and their effect on the management of vestibular schwannoma (VS).
STUDY DESIGN: Retrospective chart review.
SETTING: Tertiary referral center.
PATIENTS: Patients >18 years old with sporadic VS newly diagnosed between January 1, 2010, and December 31, 2020.
INTERVENTIONS: Magnetic resonance imaging; audiogram; treatment recommendations.
MAIN OUTCOME MEASURES: Differences in treatment recommendations for patients based on their social determinants of health, including race, ethnicity, and socioeconomic status.
RESULTS: A total of 811 patients were included in analysis. Patients with a higher area deprivation index (ADI) presented with larger tumors. A higher ADI was associated with a higher likelihood of recommending radiation (or the option of surgery or radiation) compared with a recommendation of surgery alone. Tumor grade and patient age were significantly associated with treatment recommendation. Older age was associated with a recommendation of observation alone or a recommendation of radiation. Higher tumor grade was associated with a recommendation of surgery. There was a trend for higher hearing class to be associated with a recommendation of surgery, but this did not reach statistical significance. Race, ethnicity, and gender were not significantly associated with treatment recommendation.
CONCLUSIONS: Patients with higher levels of disadvantage presented with higher tumor grade, suggesting that access to care influences diagnosis. Factors including age, ADI, and tumor grade were associated with treatment recommendation.
STUDY DESIGN: Retrospective chart review.
SETTING: Tertiary referral center.
PATIENTS: Patients >18 years old with sporadic VS newly diagnosed between January 1, 2010, and December 31, 2020.
INTERVENTIONS: Magnetic resonance imaging; audiogram; treatment recommendations.
MAIN OUTCOME MEASURES: Differences in treatment recommendations for patients based on their social determinants of health, including race, ethnicity, and socioeconomic status.
RESULTS: A total of 811 patients were included in analysis. Patients with a higher area deprivation index (ADI) presented with larger tumors. A higher ADI was associated with a higher likelihood of recommending radiation (or the option of surgery or radiation) compared with a recommendation of surgery alone. Tumor grade and patient age were significantly associated with treatment recommendation. Older age was associated with a recommendation of observation alone or a recommendation of radiation. Higher tumor grade was associated with a recommendation of surgery. There was a trend for higher hearing class to be associated with a recommendation of surgery, but this did not reach statistical significance. Race, ethnicity, and gender were not significantly associated with treatment recommendation.
CONCLUSIONS: Patients with higher levels of disadvantage presented with higher tumor grade, suggesting that access to care influences diagnosis. Factors including age, ADI, and tumor grade were associated with treatment recommendation.