Disclosures: Comron Saifi, MD: Nuvasive (Products/Services: No) (Consultant/Advisory Board, Stockholder/Ownership Interest (excluding diversified mutual funds))

Objective: The objective of this study was to evaluate racial disparities among women with spinal metastatic breast cancer undergoing spine surgery.

Design: We applied Cox proportional hazards regression to evaluate the impact of race on mortality, while generalized linear models with a binomial distribution were used to evaluate the impact of race in the process of care and complications.Setting : We made use of the SEER-Medicare (Surveillance, Epidemiology and End Results program data linked Medicare claims data) database between 2007 and 2016.Participants : All patients presented a diagnosis of breast cancer with spine metastasis selected using Medicare claims indicating a spinal procedure to treat metastasis. We excluded male patients to increase sample homogeneity as the course of disease among men tends to be more aggressive.

Interventions: All models were adjusted for age at diagnosis, tumor grade, and patient frailty (based on function-related indicators).

Main Outcome Measures: We evaluated the time from diagnosis until surgical intervention, complications, emergency department visits after discharge, hospital readmission, frailty, as well as cancer-specific and all-cause mortality.

Results: Of the 1,072 patients, a total of 158 (14.7%) patients were Black, while 914 (85.3%) were White. The proportion of Black women who underwent surgery to treat spinal metastasis within the first year of diagnosis was 21.5% vs. 19.5% for White patients. Black women had a longer length of stay, were more likely to be readmitted within 3 months from surgery, had a higher risk of Emergency Department visits within 3 months, and higher frailty score within one year from surgery. Black patients had an increased risk of complications within 90 days from discharge. Although not statistically significant, there was an increased risk of cancer-specific mortality and all-cause mortality among Black women.Conclusions: Black women undergoing spine procedures for metastatic spine cancer after breast cancer had increased risk of complications, increased healthcare utilization, and increased risk of mortality.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/racial-differences-in-the-surgical-care-of-medicare-beneficiaries-among-women-diagnosed-with-spinal-metastatic-breast-cancer/