Effect of race on procedural and clinical outcomes in middle meningeal artery embolization for primary and adjunctive treatment of chronic subdural hematoma
Bibliographic record
Abstract
Background We investigated racial disparities in radiologic and clinical outcomes of patients after middle meningeal artery embolization (MMAE) for chronic subdural hematoma (CSDH) with or without evacuation surgery. Methods This multicenter retrospective study includes consecutive patients who underwent MMAE across 11 institutions in North America (10 in the United States and 1 in Canada). Patients were stratified using self-reported racial data. Outcomes of interest were complications, treatment failure/reoperations, resolution of hematoma, and functional independence at last follow-up. Multivariable regression models were used to assess and adjust for relevant confounders. Results A total of 557 patients underwent 663 MMAEs, including 323 White (58%), 150 Black (27%), 35 Hispanic (6%), 29 Asian (5%) patients, and 20 patients (4%) self-categorized as other/nondisclosed. The median age (interquartile range) of the cohort was 75 (65–81) years, and 412 (74%) patients were female. Middle meningeal artery embolization was the primary treatment for CSDH for 369 patients (66%) and adjunct treatment for 188 (34%). Black patients had a 51% lower likelihood of reoperation relative to other racial categories (adjusted odds ratio [OR] 0.49; 95% confidence interval [CI] 0.25–0.95, p = 0.034). White patients were twice as likely (11% difference; adjusted OR 2.24; 95% CI 1.43–3.51, p < 0.001) and Black patients 59% less likely (6% difference; adjusted OR 0.41; 95% CI 0.25–0.69, p = 0.001) to be independent at last follow-up. Conclusion This study highlights significant racial disparities in outcomes after MMAE for CSDH, with or without evacuation surgery. White patients had higher reoperation rates but were more likely to be functionally independent at last follow-up. Black patients, despite better baseline functional status, had lower odds of functional independence postoperatively.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".