{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T04:12:14Z","timestamp":1780978334907,"version":"3.54.1"},"reference-count":25,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T00:00:00Z","timestamp":1707091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective Cohort Study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Although the optimal timing of surgical intervention for traumatic spinal cord injury (TSCI) is controversial, early intervention has been recognized as being beneficial in several studies. The objective of this study was to evaluate the socioeconomic factors that may delay time to surgical fixation in the management of TSCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The present study utilized the Trauma Quality Improvement Program (TQIP) dataset to identify patients aged greater than 18 undergoing spinal fusion for TSCI from 2007-2016. Patients were divided into subgroups based on race and insurance types. Multivariable linear regression was used to compare time to procedure based on race and payer type while adjusting for demographic and injury-specific factors. Significance was set at\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Using multivariable analysis, Hispanic and Black patients were associated with significantly increased time to fixation of 12.1\u00a0h (95% CI 5.5-18.7,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), and 20.1\u00a0h (95% CI 12.1-28.1,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), respectively compared to White patients. Other cohorts based on racial status did not have significantly different times to fixation (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; .05). Medicaid was associated with an increased time to fixation compared to private insurance (11.6\u00a0h, 95% CI 3.9-19.2,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Black and Hispanic race and Medicaid were associated with statistically significant increases in time to fixation following TSCI, potentially compromising quality of patient care and resulting in poorer outcomes. More research is needed to elucidate this relationship and ensure equitable care is being delivered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682231225175","type":"journal-article","created":{"date-parts":[[2024,2,6]],"date-time":"2024-02-06T02:25:55Z","timestamp":1707186355000},"page":"1129-1135","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Increased Time to Fixation After Traumatic Spinal Cord Injury Influenced by Race and Insurance Status"],"prefix":"10.1177","volume":"15","author":[{"given":"Jon","family":"Raso","sequence":"first","affiliation":[{"name":"University of Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pramod","family":"Kamalapathy","sequence":"additional","affiliation":[{"name":"University of Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Solomon","sequence":"additional","affiliation":[{"name":"Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Driskill","sequence":"additional","affiliation":[{"name":"University of Virginia School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Kurker","sequence":"additional","affiliation":[{"name":"University of Virginia School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3707-4022","authenticated-orcid":false,"given":"Aditya","family":"Joshi","sequence":"additional","affiliation":[{"name":"Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamid","family":"Hassanzadeh","sequence":"additional","affiliation":[{"name":"Johns Hopkins University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,2,5]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000004417"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.20517\/2347-8659.2019.15"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-007-0452-5"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2020.105883"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41393-019-0280-6"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2021.10.121"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/JTN.0000000000000246"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.4055\/cios20019"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/2192568218811633"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/2042533313515863"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.662876"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2012.59"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2011.10.003"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yasu.2012.05.001"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2010.04.020"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwr116"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.00485.x"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e318287f04e"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-014-1478-5"},{"key":"e_1_3_3_21_2","volume-title":"Care Without Coverage: Too Little, Too Late","author":"Institute of Medicine (US)","year":"2002","unstructured":"Institute of Medicine (US), Board on Health Care Services, Committee on the Consequences of Uninsurance. Care Without Coverage: Too Little, Too Late. Washington, DC: National Academies Press (US); 2002. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK220639\/. 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