Neuroanesthesia & neurocritical care
Insurance-Related Disparities in Withdrawal of Life Support and Mortality After Spinal Cord Injury
Main finding · WLSTResult — go to the resultAdjusted odds ratio 1.49 95% CI 1.11–2.01Authors' conclusion
Health insurance type was associated with significant differences in the odds of WLST, mortality, hospital complications, and days in hospital among patients with complete cervical SCI in this study.
Study context
- Population
- Adults (older than 16 years) with complete cervical spinal cord injury (SCI) at 498 Trauma Quality Improvement Program trauma centers, 2013–2020
- Participants
- 8,421 adults · 498 trauma centers
- Exposure
- Uninsured or public insurance vs private insurance
- Privaten = 3,524reference
- Publicn = 3,957
- Uninsuredn = 940
- Outcome
- Coprimary: withdrawal of life-supporting treatment (WLST) and mortality
Methodological detailsmulticentre registry, hierarchical logistic regression, propensity-score matched alternative analysis
- Multicentre registry
- Hierarchical logistic regression
- Propensity-score matched alternative analysis
Main finding
WLST
Adjusted odds ratio
1.49
95% CI 1.11–2.01
Events by group
Uninsured vs Private
aOR 1.49 (95% CI 1.11–2.01)
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Private | Public | Uninsured | aOR (95% CI) | |
|---|---|---|---|---|---|
| Mortality (coprimary)Uninsured vs Private | 21.5% | 30.6% | 33.8% | 1.98 (1.50–2.60) | |
| 0.20.5125Adjusted odds ratio (log scale) |
| Outcome | Mean difference (days) (95% CI) | |
|---|---|---|
| Hospital LOS (matched public vs private)Propensity-score matched · redemonstrated on subgroup analyses | 5.90 (4.64–7.20) | |
| −50510Difference, days (linear scale) |
Safety
| Outcome | OR (95% CI) | |
|---|---|---|
| Hospital complications (matched public vs private)Propensity-score matched · redemonstrated on subgroup analyses | 1.27 (1.14–1.42) | |
| 0.512Odds ratio (log scale) |
Original publication
Insurance-Related Disparities in Withdrawal of Life Support and Mortality After Spinal Cord Injury. JAMA Surg. Published 1 October 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →