Impact of Race on Outcomes in Craniotomy for Tumor: A Systematic Narrative Review

Abstract

INTRODUCTION: Craniotomy for tumor can be a complex neurosurgical procedure that relies on skill of surgeon, volume of the hospital, and patient co-morbidities. Few studies have looked at how race impacts the outcomes of these patients. METHODS: A literature search was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines identifying outcomes for craniotomy stratified by racial differences. A search of multiple bibliographic databases conducted found 194 articles. Twenty-five studies were found and were used in the final analysis (Fig. 1). Discharge disposition, mortality, complications, overall survival, emergency room visits, hospital unplanned readmissions, and hospital charges were compiled and analyzed.Figure 1RESULTS: Hospital charges, 30-day readmission, and complications were uniformly found to be worse in racial minority patients. Discharge disposition in all 5 studies showed that minority race led to in non-home discharges, with 5 studies reaching statistical significance. Overall survival and 90-day readmission had more mixed results or did not show any difference for minority patients. CONCLUSION: Outcomes for craniotomy for brain tumors have been associated with surgical skill and experience, high volume hospitals, as well as patient related medical factors. The literature suggests that outcomes are also impacted by race, and this should be addressed when working to improve patient outcome.