Skip to main content
Journal cover image

Racial, Socioeconomic, and Gender Disparities in the Presentation, Treatment, and Outcomes of Adult Chiari I Malformations.

Publication ,  Journal Article
Krucoff, MO; Cook, S; Adogwa, O; Moreno, J; Yang, S; Xie, J; Firempong, AO; Lad, N; Bagley, CA
Published in: World Neurosurg
January 2017

OBJECTIVE: To examine the influence of race, gender, and socioeconomic factors on presentations and outcomes of adult Chiari I malformations. METHODS: The charts of 638 adult patients with Chiari I malformations were reviewed, and 287 patients were included in the study. Race, gender, insurance status, symptoms, depth of cerebellar tonsillar herniation, and presence of syringomyelia were examined as covariates in multivariate logistic regression models to identify independent predictors of presentation and outcome. RESULTS: Patients with public insurance had a longer stay in the hospital (P = 0.01). A higher proportion of male patients presented with upper extremity weakness (P = 0.01), lower extremity weakness (P = 0.040), and cranial nerve findings (P = 0.02). Men had shorter onset to diagnosis times (P = 0.02), worse tonsillar herniation (P = 0.03), and more severe symptoms (P = 0.05). White patients more frequently presented with back pain (P = 0.03), and African American patients more frequently presented with lower extremity weakness (P = 0.01). African Americans had worse tonsillar herniation (P < 0.01) and were more likely to present with syringomyelia (P = 0.01). Multivariate regression analysis revealed that back pain (P < 0.01), upper extremity weakness (P ≤ 0.01), upper extremity paresthesias (P < 0.01), and upper with lower extremity paresthesias (P = 0.04) were significant predictors of syringomyelia. The only independent predictor of outcome was size of tonsillar herniation (P = 0.03). CONCLUSIONS: Significant differences in presentation of Chiari I malformation resulting from gender, race, and insurance status were quantified for the first time.

Duke Scholars

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

January 2017

Volume

97

Start / End Page

431 / 437

Location

United States

Related Subject Headings

  • Young Adult
  • White People
  • Treatment Outcome
  • Socioeconomic Factors
  • Sexism
  • Sex Distribution
  • Risk Factors
  • Racism
  • North Carolina
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Krucoff, M. O., Cook, S., Adogwa, O., Moreno, J., Yang, S., Xie, J., … Bagley, C. A. (2017). Racial, Socioeconomic, and Gender Disparities in the Presentation, Treatment, and Outcomes of Adult Chiari I Malformations. World Neurosurg, 97, 431–437. https://doi.org/10.1016/j.wneu.2016.10.026
Krucoff, Max O., Steven Cook, Owoicho Adogwa, Jessica Moreno, Siyun Yang, Jichun Xie, Alexander O. Firempong, Nandan Lad, and Carlos A. Bagley. “Racial, Socioeconomic, and Gender Disparities in the Presentation, Treatment, and Outcomes of Adult Chiari I Malformations.World Neurosurg 97 (January 2017): 431–37. https://doi.org/10.1016/j.wneu.2016.10.026.
Krucoff MO, Cook S, Adogwa O, Moreno J, Yang S, Xie J, et al. Racial, Socioeconomic, and Gender Disparities in the Presentation, Treatment, and Outcomes of Adult Chiari I Malformations. World Neurosurg. 2017 Jan;97:431–7.
Krucoff, Max O., et al. “Racial, Socioeconomic, and Gender Disparities in the Presentation, Treatment, and Outcomes of Adult Chiari I Malformations.World Neurosurg, vol. 97, Jan. 2017, pp. 431–37. Pubmed, doi:10.1016/j.wneu.2016.10.026.
Krucoff MO, Cook S, Adogwa O, Moreno J, Yang S, Xie J, Firempong AO, Lad N, Bagley CA. Racial, Socioeconomic, and Gender Disparities in the Presentation, Treatment, and Outcomes of Adult Chiari I Malformations. World Neurosurg. 2017 Jan;97:431–437.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

January 2017

Volume

97

Start / End Page

431 / 437

Location

United States

Related Subject Headings

  • Young Adult
  • White People
  • Treatment Outcome
  • Socioeconomic Factors
  • Sexism
  • Sex Distribution
  • Risk Factors
  • Racism
  • North Carolina
  • Middle Aged