Abstract
Objectives: This study sought to determine whether there is a gender disparity in patients undergoing deep brain stimulation (DBS) surgery for Parkinson's disease (PD) at a single health system, and better understand the reasons for this discrepancy. Materials and Methods: We analyzed data from the University of Miami DBS Database, which included 3251 PD patients, using chi-square, repeated measures ANOVA, and t tests to examine gender differences in the number of patients referred for surgery, reasons for referral, number receiving/not receiving surgery, reasons for not receiving surgery, and postsurgical outcomes. Results: During the study period, 207 PD patients were referred for DBS (75.8% male), and 100 underwent surgery (77.0% male). Of those who did not receive surgery, the most common reasons were need for further medical optimization (26.2%), suboptimal performance on neuropsychological evaluation (22.4%), other reason (20.6%), lost to follow-up (18.7%), or patient preference (12.2%). However, in women one of the most common reasons was patient preference (28.0%), and this was significant compared to men (p < 0.001). Men were more likely to be lost to follow-up (p = 0.046). There was no statistically significant difference in postsurgical outcomes. Conclusions: Despite similar postsurgical improvements, women were less likely to undergo DBS surgery due to their own preference, while men were more likely to be lost to follow-up. These data underscore the need for increased education and awareness of DBS so that all patients with PD who qualify for surgery can benefit from this procedure.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 484-488 |
| Number of pages | 5 |
| Journal | Neuromodulation |
| Volume | 22 |
| Issue number | 4 |
| DOIs | |
| State | Published - Jun 1 2019 |
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Keywords
- deep brain stimulation
- healthcare disparities
- Parkinson's disease
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
- Anesthesiology and Pain Medicine
Cite this
Gender Disparities in Deep Brain Stimulation for Parkinson's Disease. / Shpiner, Danielle S.; Di Luca, Daniel G.; Cajigas, Iahn; Diaz, Juan S.; Margolesky, Jason; Moore, Henry P; Levin, Bonnie E.; Singer, Carlos; Jagid, Jonathan; Luca, Corneliu C.
In: Neuromodulation, Vol. 22, No. 4, 01.06.2019, p. 484-488.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Gender Disparities in Deep Brain Stimulation for Parkinson's Disease
AU - Shpiner, Danielle S.
AU - Di Luca, Daniel G.
AU - Cajigas, Iahn
AU - Diaz, Juan S.
AU - Margolesky, Jason
AU - Moore, Henry P
AU - Levin, Bonnie E.
AU - Singer, Carlos
AU - Jagid, Jonathan
AU - Luca, Corneliu C
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Objectives: This study sought to determine whether there is a gender disparity in patients undergoing deep brain stimulation (DBS) surgery for Parkinson's disease (PD) at a single health system, and better understand the reasons for this discrepancy. Materials and Methods: We analyzed data from the University of Miami DBS Database, which included 3251 PD patients, using chi-square, repeated measures ANOVA, and t tests to examine gender differences in the number of patients referred for surgery, reasons for referral, number receiving/not receiving surgery, reasons for not receiving surgery, and postsurgical outcomes. Results: During the study period, 207 PD patients were referred for DBS (75.8% male), and 100 underwent surgery (77.0% male). Of those who did not receive surgery, the most common reasons were need for further medical optimization (26.2%), suboptimal performance on neuropsychological evaluation (22.4%), other reason (20.6%), lost to follow-up (18.7%), or patient preference (12.2%). However, in women one of the most common reasons was patient preference (28.0%), and this was significant compared to men (p < 0.001). Men were more likely to be lost to follow-up (p = 0.046). There was no statistically significant difference in postsurgical outcomes. Conclusions: Despite similar postsurgical improvements, women were less likely to undergo DBS surgery due to their own preference, while men were more likely to be lost to follow-up. These data underscore the need for increased education and awareness of DBS so that all patients with PD who qualify for surgery can benefit from this procedure.
AB - Objectives: This study sought to determine whether there is a gender disparity in patients undergoing deep brain stimulation (DBS) surgery for Parkinson's disease (PD) at a single health system, and better understand the reasons for this discrepancy. Materials and Methods: We analyzed data from the University of Miami DBS Database, which included 3251 PD patients, using chi-square, repeated measures ANOVA, and t tests to examine gender differences in the number of patients referred for surgery, reasons for referral, number receiving/not receiving surgery, reasons for not receiving surgery, and postsurgical outcomes. Results: During the study period, 207 PD patients were referred for DBS (75.8% male), and 100 underwent surgery (77.0% male). Of those who did not receive surgery, the most common reasons were need for further medical optimization (26.2%), suboptimal performance on neuropsychological evaluation (22.4%), other reason (20.6%), lost to follow-up (18.7%), or patient preference (12.2%). However, in women one of the most common reasons was patient preference (28.0%), and this was significant compared to men (p < 0.001). Men were more likely to be lost to follow-up (p = 0.046). There was no statistically significant difference in postsurgical outcomes. Conclusions: Despite similar postsurgical improvements, women were less likely to undergo DBS surgery due to their own preference, while men were more likely to be lost to follow-up. These data underscore the need for increased education and awareness of DBS so that all patients with PD who qualify for surgery can benefit from this procedure.
KW - deep brain stimulation
KW - healthcare disparities
KW - Parkinson's disease
UR - http://www.scopus.com/inward/record.url?scp=85066911262&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85066911262&partnerID=8YFLogxK
U2 - 10.1111/ner.12973
DO - 10.1111/ner.12973
M3 - Article
VL - 22
SP - 484
EP - 488
JO - Neuromodulation
JF - Neuromodulation
SN - 1094-7159
IS - 4
ER -