Socioeconomic deprivation and long-term outcomes after elective surgery: analysis of prospective data from two observational studies

British Journal of Anaesthesia

Volumn 126, Issue 3, 2021, Pages 642-651

  Wan, Yize I ^a,b   McGuckin, Dermot ^c,d   Fowler, Alexander J ^a,b   Prowle, John R ^a,b   Pearse, Rupert M ^a,b   Moonesinghe, S Ramani ^c,d,e  

^a QUEEN MARY UNIVERSITY OF LONDON   (United Kingdom)

^b BARTS HEALTH NHS TRUST   (United Kingdom)

^c Department of Targeted Intervention   (United Kingdom)

^d UNIVERSITY COLLEGE LONDON   (United Kingdom)

^e National Institute of Academic Anaesthesia   (United Kingdom)

Author keywords

healthcare disparities; mortality; postoperative complications; socioeconomic factors; surgery; survival

Indexed keywords

CREATININE; HEMOGLOBIN;

ACUTE KIDNEY FAILURE; ADULT; ADULT RESPIRATORY DISTRESS SYNDROME; AGED; ANASTOMOSIS LEAKAGE; ARTICLE; ASTHMA; CEREBROVASCULAR ACCIDENT; CHRONIC OBSTRUCTIVE LUNG DISEASE; CLINICAL OUTCOME; COHORT ANALYSIS; CONTROLLED STUDY; DIABETES MELLITUS; ELECTIVE SURGERY; FEMALE; GASTROINTESTINAL HEMORRHAGE; HEART ARREST; HOSPITALIZATION; HUMAN; LENGTH OF STAY; LUNG EDEMA; LUNG EMBOLISM; MAJOR CLINICAL STUDY; MALE; MORTALITY RATE; OBSERVATIONAL STUDY; PNEUMONIA; POSTOPERATIVE HEMORRHAGE; POSTOPERATIVE INFECTION; POSTOPERATIVE INFLAMMATION; PRIORITY JOURNAL; PROSPECTIVE STUDY; SOCIAL STATUS; SOCIOECONOMIC DEPRIVATION; SURGICAL INFECTION; SURVIVAL; SURVIVAL ANALYSIS; URINARY TRACT INFECTION; HEALTH CARE DELIVERY; MORTALITY; POSTOPERATIVE COMPLICATION; PROPORTIONAL HAZARDS MODEL; SOCIOECONOMICS;

DELIVERY OF HEALTH CARE; ELECTIVE SURGICAL PROCEDURES; HUMANS; POSTOPERATIVE COMPLICATIONS; PROPORTIONAL HAZARDS MODELS; PROSPECTIVE STUDIES; SOCIOECONOMIC FACTORS; SURVIVAL ANALYSIS;

EID: 85096435122     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1016/j.bja.2020.10.019     Document Type: Article

References (37)

1. Abbott, T.E.F., Fowler, A.J., Dobbs, T.D., Harrison, E.M., Gillies, M.A., Pearse, R.M., Frequency of surgical treatment and related hospital procedures in the UK: a national ecological study using hospital episode statistics. Br J Anaesth 119 (2017), 249–257.
2. Pearse, R.M., Moreno, R.P., Bauer, P., et al. Mortality after surgery in Europe: a 7 day cohort study. Lancet 380 (2012), 1059–1065.
3. International Surgical Outcomes Study group. Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries. Br J Anaesth, 119, 2017, 553.
4. Hart, J.T., The inverse care law. Lancet 1 (1971), 405–412.
5. Barnett, K., Mercer, S.W., Norbury, M., Watt, G., Wyke, S., Guthrie, B., Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 380 (2012), 37–43.
6. Office of National Statistics, Health state life expectancies by index of multiple deprivation (IMD): England, 2013 to 2015. London. 2017.
7. Newton, J.N., Briggs, A.D., Murray, C.J., et al. Changes in health in England, with analysis by English regions and areas of deprivation, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 386 (2015), 2257–2274.
8. Mackenbach, J.P., Stirbu, I., Roskam, A.J., et al. Socioeconomic inequalities in health in 22 European countries. N Engl J Med 358 (2008), 2468–2481.
9. Rachet, B., Ellis, L., Maringe, C., et al. Socioeconomic inequalities in cancer survival in England after the NHS cancer plan. Br J Cancer 103 (2010), 446–453.
10. Marmot, M., Friel, S., Bell, R., Houweling, T.A., Taylor, S., Commisson on Social Determinants of Health. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet 372 (2008), 1661–1669.
11. Poulton, T.E., Salih, T., Martin, P., Rojas-Garcia, A., Raine, R., Moonesinghe, S.R., Systematic review of the influence of socioeconomic deprivation on mortality after colorectal surgery. BJS 105 (2018), 959–970.
12. Donkers, H., Bekkers, R., Massuger, L., Galaal, K., Systematic review on socioeconomic deprivation and survival in endometrial cancer. Cancer Causes Control 30 (2019), 1013–1022.
13. Hollowell, J., Grocott, M.P., Hardy, R., Haddad, F.S., Mythen, M.G., Raine, R., Major elective joint replacement surgery: socioeconomic variations in surgical risk, postoperative morbidity and length of stay. J Eval Clin Pract 16 (2010), 529–538.
14. Mirza, A.H., Aylin, P., Middleton, S., King, E.V., Nouraei, R.A.R., Repanos, C., Impact of social deprivation on the outcome of major head and neck cancer surgery in England: a national analysis. Head Neck 41 (2019), 692–700.
15. Belot, A., Fowler, H., Njagi, E.N., et al. Association between age, deprivation and specific comorbid conditions and the receipt of major surgery in patients with non-small cell lung cancer in England: a population-based study. Thorax 74 (2019), 51–59.
16. Poulton, T.E., Moonesinghe, R., Raine, R., Martin, P., National Emergency Laparotomy Audit project team. Socioeconomic deprivation and mortality after emergency laparotomy: an observational epidemiological study. Br J Anaesth 124 (2020), 73–83.
17. Raine, R., Wong, W., Scholes, S., Ashton, C., Obichere, A., Ambler, G., Social variations in access to hospital care for patients with colorectal, breast, and lung cancer between 1999 and 2006: retrospective analysis of hospital episode statistics. BMJ, 340, 2010, b5479.
18. Jerath, A., Austin, P.C., Ko, D.T., et al. Socioeconomic status and days alive and out of hospital after major elective noncardiac surgery: a population-based cohort atudy. Anesthesiology 132 (2020), 713–722.
19. Vascular Events In Noncardiac Surgery Patients Cohort Evaluation Study Devereaux, P.J., Chan, M.T., Alonso-Coello, P., et al. Association between postoperative troponin levels and 30-day mortality among patients undergoing noncardiac surgery. JAMA 307 (2012), 2295–2304.
20. Office of National Statistics. English indices of deprivation 2019. 2019.
21. Wan, Y.I., McGuckin, D., Fowler, A.J., Prowle, J.R., Pearse, R.M., Moonesinghe, S.R., Socioeconomic deprivation and surgical outcomes: ISOS and VISION-UK sub-study (Statistical Analysis Plan). 2020 Available from: https://qmro.qmul.ac.uk/xmlui/. (Accessed 7 July 2020)
22. Marmot, M., Goldblatt, P., Allen, J., et al. Fair society, healthier lives: the marmot review (strategic review of health inequalities in England post-2010). London. 2010 Available from: http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review. (Accessed 10 July 2020)
23. Cookson, R., Asaria, M., Ali, S., et al. Health Equity Indicators for the English NHS: a longitudinal whole-population study at the small-area level. 2016, Health Services and Delivery Rsearch, Southampton, UK.
24. Ellaway, A., Benzeval, M., Green, M., Leyland, A., Macintyre, S., “Getting sicker quicker”: does living in a more deprived neighbourhood mean your health deteriorates faster?. Health Place 18 (2012), 132–137.
25. Apea, V.J., Wan, Y.I., Dhairyawan, R., et al. Ethnicity and outcomes in patients hospitalised with COVID-19 infection in East London: an observational cohort study. medRxiv, 2020 06.10.20127621.
26. Stringhini, S., Sabia, S., Shipley, M., et al. Association of socioeconomic position with health behaviors and mortality. JAMA 303 (2010), 1159–1166.
27. Connolly, V., Unwin, N., Sherriff, P., Bilous, R., Kelly, W., Diabetes prevalence and socioeconomic status: a population based study showing increased prevalence of type 2 diabetes mellitus in deprived areas. J Epidemiol Community Health 54 (2000), 173–177.
28. Pleasants, R.A., Riley, I.L., Mannino, D.M., Defining and targeting health disparities in chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 11 (2016), 2475–2496.
29. McLean, E., Cogswell, M., Egli, I., Wojdyla, D., de Benoist, B., Worldwide prevalence of anaemia, WHO vitamin and mineral nutrition information system, 1993–2005. Public Health Nutr 12 (2009), 444–454.
30. Exarchakou, A., Rachet, B., Belot, A., Maringe, C., Coleman, M.P., Impact of national cancer policies on cancer survival trends and socioeconomic inequalities in England, 1996–2013: population based study. BMJ, 360, 2018, k764.
31. Agabiti, N., Cesaroni, G., Picciotto, S., et al. The association of socioeconomic disadvantage with postoperative complications after major elective cardiovascular surgery. J Epidemiol Community Health 62 (2008), 882–889.
32. Martin, E.T., Kaye, K.S., Knott, C., et al. Diabetes and risk of surgical site infection: a systematic review and meta-analysis. Infect Control Hosp Epidemiol 37 (2016), 88–99.
33. van den Berg, I., Buettner, S., van den Braak, R.R.J.C., et al. Low socioeconomic status is associated with worse outcomes after curative surgery for colorectal cancer: results from a large, multicenter study. J Gastrointest Surg 24 (2020), 2628–2636.
34. Pell, J.P., Pell, A.C., Norrie, J., Ford, I., Cobbe, S.M., Effect of socioeconomic deprivation on waiting time for cardiac surgery: retrospective cohort study. BMJ 320 (2000), 15–18.
35. Bagger, J.P., Edwards, M.B., Taylor, K.M., Influence of socioeconomic status on survival after primary aortic or mitral valve replacement. Heart 94 (2008), 182–185.
36. Chen, R., McKevitt, C., Rudd, A.G., Wolfe, C.D., Socioeconomic deprivation and survival after stroke: findings from the prospective South London Stroke Register of 1995 to 2011. Stroke 45 (2014), 217–223.
37. Oliphant, R., Nicholson, G.A., Horgan, P.G., et al. Deprivation and colorectal cancer surgery: longer-term survival inequalities are due to differential postoperative mortality between socioeconomic groups. Ann Surg Oncol 20 (2013), 2132–2139.