Racial Differences in Surgical Complications Following Traumatic Brain Injury Surgery: A Cohort Analysis

Introduction: Traumatic brain injury (TBI) is a significant public health concern, particularly in older adults. The complications associated with TBI can significantly influence patient outcomes, and racial disparities may further impact recovery. This study examines the incidence of common TBI-related complications, with a focus on racial differences.

Methods: We used the ACS-NSQIP dataset to identify patients who underwent craniectomy for Traumatic Brain Injury as a primary procedure from 2016 to 2021. We selected cases using specific CPT codes: 61304, 61305, 61312, 61306, 61345, 61320, 61322, 61100, and 61321. Additional filters were applied using TBI-related diagnoses based on ICD-10 codes to refine our cohort further. T-tests were used to compare continuous variables and Chi-Squared tests for categorical variables. Univariate analysis assessed the association between racial groups and surgical complication.

Results: The cohort consisted of 2,093 patients, with a mean age of 69.58 years (SD = 15.02). Among white patients, 24.2% experienced a bleeding complication, compared to 16.6% African American and Asian patients (p < 0.001). Sepsis rates were similar, 23.6% for whites and 24.1% for African American/Asian patients (p = 0.835). Hyponatremia occurred more frequently in white patients (19.3%) than in African American and Asian patients (11.0%) (p < 0.001). Surgical site infections (SSI) were reported in 0.4% of white patients and 0.9% of African American/Asian patients (p = 0.233). Acute renal failure was more common in African American and Asian patients (2.2%) compared to white patients (0.2%) (p < 0.001).

Conclusion : This study highlights significant racial disparities in complications following TBI surgery. White patients had higher rates of bleeding and hyponatremia, while African American and Asian patients experienced higher rates of acute renal failure. These findings emphasize the need for tailored medical interventions that address these racial disparities and improve outcomes for all patients suffering from TBI.