Medical Student Tufts University School of Medicine Royersford, PA, US
Disclosure(s):
Hiba Hamid, BA: No financial relationships to disclose
Introduction: Socioeconomic factors such as employment are being increasingly recognized as significant determinants of post-operative outcomes following surgery. However, research specifically on neurosurgical outcomes is scarce. This study aimed to assess the impact of employment status on recovery metrics, including pain improvement, hospital stay duration, and readmission rates following cervical spine surgery.
Methods: Using data from the Quality Outcomes Database, we conducted a retrospective analysis of patients aged under 55 who underwent cervical spine surgery. Older patients were excluded to eliminate possible confounding by age. Patients were categorized based on their employment status (employed, unemployed, or employed but not working). Key variables such as age, BMI, surgery duration, and hospital stay were compared across groups. Pain improvement was measured at 3- and 12-months post-operation via the Visual Analogue Scale (VAS), while hospital readmission and return to operating room (OR) rates were also evaluated.
Results: A total of 2,731 patients were included. Unemployed patients experienced longer surgeries (110.7 vs 103.3 min, p< 0.01) and hospital stays (1.2 vs 0.8 days, p< 0.01) compared to employed patients. Unemployed patients also demonstrated worse pain improvement at both 3- and 12-months post-surgery (9.3 vs 12.2, p< 0.0184; 9.1 vs 12.5, p< 0.00013) and had higher rates of readmission (2.9% vs 1.4%, p< 0.04392) and return to the OR (1.1% vs 0.8%, p< 0.001) when compared to the employed group. Females were overrepresented in the unemployed group, possibly due to socioeconomic disparities and caregiving responsibilities (p < 0.001). "Employed but not working" patients reported better pain improvement, suggesting fewer stressors during recovery (p < 0.0013).
Conclusion : Employment status significantly impacts post-operative recovery in cervical spine surgery patients. Unemployed patients experience worse pain outcomes, longer hospital stays, and more frequent readmissions. The underlying causes of these disparities highlight the necessity for further research. Addressing these socioeconomic disparities may improve surgical outcomes and recovery processes.