@article{ref1,
title="Preinjury social determinants of health disparities predict postinjury psychosocial conditions in adult traumatic brachial plexus injuries",
journal="Neurosurgery",
year="2023",
author="Maasarani, Samantha and DeLeonibus, Anthony and Wee, Corinne and Leavitt, Tripp and Lee, Christina D. and Khalid, Syed I. and Layon, Sarah and Gharb, Bahar Bassiri and Rampazzo, Antonio and Noland, Shelley S.",
volume="93",
number="1",
pages="215-223",
abstract="BACKGROUND: Adult traumatic brachial plexus injuries (TBPIs) are life-altering events that can have detrimental effects on a patient's quality of life. <br><br>OBJECTIVE: To examine how social determinants of health (SDOH) disparities influence the risk of developing new psychosocial conditions after TBPIs in previously psychiatric-naïve patients. <br><br>METHODS: Between January 2010 and June 2019, a retrospective analysis was performed using PearlDiver's Mariner, an all-payer claims database, to create 3 cohorts: TBPI disparity cohort: patients with TBPI and presence of at least 1 SDOH disparity before injury, TBPI without disparity cohort: patients with TBPI and the absence of any SDOH disparity, and control cohort: patients without TBPIs. <br><br>RESULTS: The matched population analyzed in this study consisted of 1176 patients who were equally represented in the TBPI disparity cohort (n = 392, 33.33%), TBPI without disparity cohort (n = 392, 33.33%), and control cohort (n = 392, 33.33%). A total of 301 patients developed any psychosocial condition with 4 years of their injury. Patients in the TBPI disparity cohort had significantly higher rates of developing any psychosocial condition (31.12%, P <.0005), depression (22.70%, P =.0032), anxiety (18.62%, P =.0203), drug abuse (7.91%, P =.0060), and alcohol abuse (4.85%, P =.03499) when compared with the other cohorts. Furthermore, the disparity cohort carried a significantly increased risk of developing any psychosocial condition (hazard ratio 1.42, 95% CI 1.09-1.86). The rates of suicide attempt, post-traumatic stress disorder, and divorce did not significantly differ between groups. <br><br>CONCLUSION: TBPI patients with SDOH disparities are at increased risk of developing new-onset psychosocial conditions, such as depression, anxiety, drug abuse, and alcohol abuse. Level of Evidence: Prognostic Level III.<p /> <p>Language: en</p>",
language="en",
issn="0148-396X",
doi="10.1227/neu.0000000000002406",
url="http://dx.doi.org/10.1227/neu.0000000000002406"
}