Key result
Living in a severely distressed community was independently associated with increased postoperative complications (9.8% vs 8.5%; OR 1.07, 95% CI 1.04-1.10; p<0.0001) and resource utilization.
Why the study?
Socioeconomic status affects surgical outcomes, but these factors are not included in clinical quality improvement data and risk models.
Does severe community distress (DCI >75) increase postoperative complications and resource utilisation in patients undergoing surgery?
Population
44,451 surgical patients in a regional ACS-NSQIP registry
Comparison
Top quartile of distress (DCI >75) vs remainder of cohort
Design
Prospective registry analysis
Authors
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May enhance preoperative risk models; leaves open whether community interventions reduce disparities.
Cohort (n=44,451)
Yes
Does severe community distress (DCI >75) increase postoperative complications and resource utilisation in patients undergoing surgery?
Odds Ratio: 1.07 (95% CI 1.04–1.1)
Absolute Event Rate: 9.8% vs 8.5%
p-value: p=<0.0001
Community-level socioeconomic distress is independently associated with increased postoperative complications and resource utilization, highlighting disparities not captured by standard clinical risk models.
Mehaffey et al. (2019) conducted a cohort in Patients undergoing surgery (n=44,451). Severely distressed communities (DCI >75) vs. Remainder of the cohort (lower distress) was evaluated on Postoperative complications (OR 1.07, 95% CI 1.04 to 1.10, p=<0.0001). Living in a severely distressed community was independently associated with increased postoperative complications (9.8% vs 8.5%; OR 1.07, 95% CI 1.04-1.10; p<0.0001) and resource utilization.
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