1401. Low Socioeconomic Status Predicts Radiation Treatment post-Glioblastoma Resection
Authors: Krissia Margarita Rivera Perla; Shayla Durfey; Oliver Tang; Karim ReFaey; Shashwat Tripathi; Ian Parney; Alfredo Quiñones-Hinojosa; Steven Toms (Providence, RI)
The impact of socioeconomic status (SES) on health outcomes has been well-characterized. The correlation between SES and all-cause mortality using the Area Deprivation Index (ADI), which aggregates 17 socioeconomic factors, has been previously demonstrated. The aim of this study was to investigate the relationship between SES and length of survival post-glioblastoma (GBM) resection.
The Mayo Clinic in Jacksonville, Florida and Rochester, Minnesota tumor databases were searched for patients with a pathology report-confirmed GBM diagnosis. Patients who underwent glioblastoma resection between January 2012 and January 2017 were included. Clinical outcome data were extracted from patient charts and patient addresses matched to ADI national percentiles. The primary outcome, post-surgery length of survival, was assessed along with Karnofsky Performance Score, tumor-treating fields, participation in a clinical trial, radiation, chemotherapy, and MGMT status as secondary outcome measures.
Statistical analysis was conducted using R statistics software. Patients were stratified by ADI national percentile by comparing the lowest 33% (higher SES) to the highest 66%. Multivariate regression was performed to adjust for age, sex, and insurance status. Odds ratios were used to determine the association between primary outcomes, secondary outcomes, and ADI percentile.
A total of 240 patients met the inclusion criteria and were included in this analysis. The average age was 60.2 years, 40.42% female, 95.83% Caucasian, and 97.5% insured. There was no difference between ADI national percentile and length of survival (OR, 0.98; 95% CI, 0.82–1.20; P= 0.87). A significant difference was found between ADI and radiation (OR, 1.28; 95% CI, 1.11—3.45; P<0.05). No significant association was found between ADI and baseline KPS, tumor-treating fields, clinical trials, chemotherapy, and MGMT status.
Patients from lower socioeconomic statuses, higher ADI percentiles, are less likely to receive radiation post-glioblastoma resection.