INFLUENCE OF ETHNICITY AND NZ DEPRIVATION INDEX ON COMPLICATIONS FOLLOWING SPINAL SURGERY

Introduction Understanding the risk of complications following surgery is essential for patient counselling but also, in the New Zealand context, accurately prioritising care within the public healthy system. This study aimed to assess the influence of ethnicity and social deprivation on complications following spine surgery. Method A cohort of 482 patients were analysed. Patients were undergoing spine surgery for any reason. Demographic variables, NZ Deprivation Indices, distance from hospital and comorbid conditions were collected. Outcomes of interest included any medical complications, surgical site infection, length of stay, readmission within 30-days and 1-year mortality. Univariate and multivariate analyses were performed to identify predictive variables. Results Mean age 56 years; 273 male (56%). There were 314 NZ European (65%), 108 Māori (22%) and 60 ‘other ethnicities’ (13%). Māori were on average slightly younger and had greater NZDepIndex. There was very little influence of ethnicity or social deprivation on any outcome except for readmission within 30-days (Māori OR 1.05-14.02%). Increased age, increased ASA (OR 1.03-1.16) and increased surgical invasiveness (OR 1.01 – 1.02) were all predictive of medical complications. History of malignancy (OR 1.01 – 1.13), albumin (0.993 – 0.999) were predictive of increased risk of SSI. Rurality (distance from hospital) was equivocally associated. Discussion and Conclusions In this single centre analysis, neither ethnicity nor social deprivation provided any major predictive value for complications following spinal surgery. As Rumball-Smith et al. have reported, Māori were more likely to be readmitted. Robust prospective data collection will help us identify modifiable variables and identify ‘at risk’ patient cohorts. Enhanced pre-operative counselling and post-operative support are desirable for Māori.