Association of area deprivation index (ADI) with demographics and postoperative outcomes in pediatric brain tumor patients

Purpose Although social determinants of health (SDOH) have been associated with adverse surgical outcomes, cumulative effects of multiple SDOH have never been studied. The area deprivation index (ADI) assesses cumulative impact of SDOH factors on outcomes. We analyzed the relationship between ADI pe...

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Bibliographic Details
Published in:Child's nervous system 2024, Vol.40 (1), p.79-86
Main Authors: Aguirre, Alexander O., Lim, Jaims, Baig, Ammad A., Ruggiero, Nicco, Siddiqi, Manhal, Recker, Matthew J., Li, Veetai, Reynolds, Renée M.
Format: Article
Language:English
Subjects:
Brain Neoplasms - surgery
Child
Demography
Humans
Medicine
Medicine & Public Health
Neurosciences
Neurosurgery
Original Article
Postoperative Period
Retrospective Studies
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Summary:Purpose Although social determinants of health (SDOH) have been associated with adverse surgical outcomes, cumulative effects of multiple SDOH have never been studied. The area deprivation index (ADI) assesses cumulative impact of SDOH factors on outcomes. We analyzed the relationship between ADI percentile and postoperative outcomes in pediatric patients diagnosed with brain tumors. Methods A retrospective, observational study was conducted on our consecutive series of pediatric brain tumor patients presenting between January 1, 1999, and May 31, 2022. Demographics and outcomes were collected, identifying SDOH factors influencing outcomes found in the literature. ADI percentiles were identified based on patient addresses, and patients were stratified into more (ADI 0–72%) and less (ADI 73–100%) disadvantaged cohorts. Univariate and multivariate logistic regression analyses were completed for demographics and outcomes. Results A total of 272 patients were included. Demographics occurring frequently in the more disadvantaged group were Black race (13.1% vs. 2.8%; P  = .003), public insurance (51.5% vs. 27.5%; P  
ISSN:0256-7040
1433-0350
DOI:10.1007/s00381-023-06098-6