Ignacio Mesina-Estarrón, Department of Neurosurgery, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America; Harvard Medical School, Boston, Massachusetts, United States of America;
Daniela Limbania, Department of Neurosurgery, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America; Harvard Medical School, Boston, Massachusetts, United States of America;
Azra Gül, Department of Neurosurgery, Leids University Medical Center, Leiden, Netherlands
Kevin Huang, Department of Neurosurgery, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America; Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts, United States of America
Background: Language barriers may contribute to in-hospital outcome disparities, particularly among immigrants with neurosurgical conditions. In patients with non-acute subdural hematomas, effective verbal communication is critical for recovery as they face a significant comorbidity burden. However, the impact of language discordance on outcomes in this population remains unclear. Objective: To investigate the association between primary language and short-term outcomes in patients with non-acute subdural hematomas (NASDH). Methods: We conducted a retrospective cohort study of adults treated for NASDH at a single academic center between January 2017 and September 2024. Patients were stratified based on the primary language documented in the electronic health record, categorized as English or non-English. Length of hospitalization was analyzed using Mann–Whitney’s U and multivariable linear regression. Adverse events and discharge disposition were assessed using Fisher’s exact tests and multivariable logistic regression. Results: Among 437 patients, 47 (11%) primarily spoke a language other than English, and 301 (69%) were male. Patients with a different primary language were overrepresented in the highest quintile of socioeconomic deprivation (p < 0.001). Interpretation services were provided to 87% of patients who had a primary language other than English. There were no significant differences in length of stay (adjusted β: 0.03; 95% confidence interval [CI]: –0.23-0.23; p = 0.82), adverse events (adjusted odds ratio [OR]: 0.80; 95% CI: 0.34-1.77; p = 0.59), or discharge home (adjusted OR: 1.37; 95% CI: 0.65-2.95; p = 0.40). Conclusion: Primary language was not associated with short-term outcomes in patients with NASDH. Further research is necessary to investigate disparities across neurosurgical patient populations with diverse linguistic backgrounds.
Keywords: Language. Subdural hematoma. Communication. Clinical outcomes. Social determinants of health. Interpretation.
