Impact of race/ethnicity on recovery and socioeconomic changes after spinal cord injury: A multicenter analysis

This study investigates the impact of race and ethnicity on clinical and socioeconomic recovery following a spinal cord injury (SCI). The goal was to determine if racial or ethnic disparities exist in neurologic outcomes, rehospitalization rates, and socioeconomic changes one year after injury. We conducted a retrospective analysis of 3,382 patients with traumatic SCI from the NSCIMS Database, collecting data on demographics, injury characteristics, and outcomes at discharge and one year. Patients were divided into two cohorts: White and Other Race, Non-White. We used comparative statistical analyses, including ANOVA and chi-square tests, and univariate and multivariate logistic regression models to assess associations while controlling for potential confounders. At baseline, significant differences were observed. Non-White patients were younger with lower incomes, higher Medicaid coverage, and more frequent violent mechanisms of injury compared to White patients. While unadjusted analyses showed associations between race/ethnicity and outcomes like spine surgery and rehospitalization, these relationships were attenuated after adjusting for clinical and socioeconomic factors in multivariate models. Neurologic outcomes were not significantly different between groups. However, race/ethnicity remained independently associated with changes in primary occupation and insurance status at one year. Our findings suggest that, after accounting for clinical and socioeconomic factors, neurologic recovery and rehospitalization rates are largely independent of race/ethnicity. However, demographic factors appear to have a lasting influence on socioeconomic recovery, specifically regarding occupational status and insurance changes. These results underscore the need for targeted interventions to address socioeconomic disparities in the long-term recovery of SCI patients.