Key result
Patients in the most deprived socioeconomic quintile had higher odds of having at least one surgical risk factor compared to the least deprived quintile (64.2% vs 48%; OR 1.9; 95% CI 1.9-2.0).
Why the study?
To examine the association of risk factors with socioeconomic deprivation in patients waiting for high volume low complexity surgical procedures in the North East and North Cumbria region.
Is socioeconomic deprivation associated with an increased prevalence of risk factors in patients waiting for elective surgery?
Cross-Sectional (n=78,571)
Yes
Is socioeconomic deprivation associated with an increased prevalence of risk factors in patients waiting for elective surgery?
Odds Ratio: 1.9 (95% CI 1.9–2)
Absolute Event Rate: 64.2% vs 48%
Patients from more socioeconomically deprived areas waiting for elective surgery have a significantly higher burden of risk factors, emphasizing the need to tailor perioperative services to mitigate health inequalities.
May support equity-focused preoperative assessment in deprived populations; leaves open whether interventions improve surgical outcomes.
OBJECTIVES: We examined the association of risk factors with socioeconomic deprivation in patients waiting for high volume low complexity (HVLC) surgical procedures in the North East and North Cumbria region. SETTINGS: We analysed data from the Rapid Actionable Insight Driving Reform database which links primary and secondary care elective waiting list data. PARTICIPANTS: Patients were included if they were waiting for HVLC surgery or an initial outpatient appointment for HVLC surgery. OUTCOMES: Smoking status, living with obesity, type 2 diabetes mellitus (T2DM), atrial fibrillation, chronic obstructive pulmonary disease (COPD), hypertension, serious mental illness or learning disability. Differences in outcomes by the England Index of Multiple Deprivation score quintiles were examined using ORs (95% CI). RESULTS: Of 78 571 patients, 30.6% were living in the most deprived quintile, 29.4% were living with obesity, 28.9% had hypertension and 13.5% were smokers. Though younger, 64.2% of patients in the most deprived quintile had at least one risk factor compared with 48% of patients in the least deprived quintile (OR 1.9 (95% CI 1.9, 2.0). The odds of being a smoker, living with obesity, T2DM, COPD and a serious mental illness or learning disability decreased as deprivation decreased in a dose-response relationship. CONCLUSIONS: People waiting for surgery from areas of greater deprivation are living with significantly more risk factors, and this may impact eligibility for surgery and surgical outcomes. Perioperative service provision must be delivered with deprivation in mind, otherwise health inequalities will be amplified.
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Madigan et al. (2025) conducted a cross-sectional in Waiting for high volume low complexity (HVLC) surgical procedures (n=78,571). Most deprived socioeconomic quintile vs. Least deprived socioeconomic quintile was evaluated on Having at least one risk factor (OR 1.9, 95% CI 1.9-2.0). Patients in the most deprived socioeconomic quintile had higher odds of having at least one surgical risk factor compared to the least deprived quintile (64.2% vs 48%; OR 1.9; 95% CI 1.9-2.0).
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