TY  - JOUR
PY  - 2023//
TI  - Preinjury social determinants of health disparities predict postinjury psychosocial conditions in adult traumatic brachial plexus injuries
JO  - Neurosurgery
A1  - Maasarani, Samantha
A1  - DeLeonibus, Anthony
A1  - Wee, Corinne
A1  - Leavitt, Tripp
A1  - Lee, Christina D.
A1  - Khalid, Syed I.
A1  - Layon, Sarah
A1  - Gharb, Bahar Bassiri
A1  - Rampazzo, Antonio
A1  - Noland, Shelley S.
SP  - 215
EP  - 223
VL  - 93
IS  - 1
N2  - 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>
LA  - en
SN  - 0148-396X
UR  - http://dx.doi.org/10.1227/neu.0000000000002406
ID  - ref1
ER  -