Key result
Socioeconomic status was not significantly associated with 30-day mortality (OR 0.55 for most vs least materially deprived) or long-term survival after elective abdominal aortic aneurysm repair.
Why the study?
The association between socioeconomic status and outcomes after abdominal aortic aneurysm repair in publicly funded health care systems is poorly described.
Does socioeconomic status affect short- or long-term mortality in patients undergoing elective abdominal aortic aneurysm repair in a publicly funded health care system?
Cohort (n=1,913)
Does socioeconomic status affect short- or long-term mortality in patients undergoing elective abdominal aortic aneurysm repair in a publicly funded health care system?
Odds Ratio: 0.55 (95% CI 0.19–1.6)
Absolute Event Rate: 1.7% vs 3.2%
p-value: p=NS
In a publicly funded health care system, socioeconomic status does not appear to significantly affect short- or long-term mortality after elective abdominal aortic aneurysm repair.
Background: The association between socioeconomic status (SES) and outcomes after abdominal aortic aneurysm (AAA) repair in publicly funded health care systems is poorly described. The purpose of this study was to determine the effect of SES on postoperative outcomes in patients who underwent AAA repair in Nova Scotia, Canada. Methods: We performed a retrospective analysis of all elective AAA repairs in Nova Scotia between November 2005 and March 2015 using administrative data sources. We compared postoperative 30-day outcomes and long-term survival across socio-economic quintiles, defined as the Pampalon Material Deprivation Index (MDI) and Social Deprivation Index (SDI). We also compared the relation between baseline characteristics, MDI quintile, SDI quintile and 30-day mortality. We used multivariable logistic regression and survival analysis to calculate adjusted 30-day mortality and long-term survival, respectively. Results: A total of 1913 patients underwent AAA repair during the study period. The overall 30-day mortality rate was 2.6% (50 patients). Thirty-day outcomes including death (p = 0.8), stroke (p = 0.7), myocardial infarction (p = 0.06), length of stay (p = 0.3) and discharge disposition other than home (p = 0.8) were similar across MDI quintiles. Similarly, there was no statistically significant association between SDI quintile and postoperative outcomes. Multivariable analysis showed that age greater than 70 years (odds ratio [OR] 3.06, 95% confidence interval [CI] 1.55–6.06) and open repair (OR 3.22, 95% CI 1.59–6.52) but not MDI quintile (p = NS) or SDI quintile (p = NS) were associated with increased 30-day mortality. There was no effect of MDI or SDI quintile on long-term survival on univariable or multivariable analysis. Conclusion: Socioeconomic status does not appear to affect short- or long-term mortality after AAA repair in a publicly funded health care system. Further research is needed to address any existing gaps in screening and referral before repair.
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McDougall et al. (2023) conducted a cohort in Elective abdominal aortic aneurysm (AAA) (n=1,913). Socioeconomic status (Material and Social Deprivation Indices) vs. Least deprived socioeconomic quintile was evaluated on 30-day mortality (OR 0.55, 95% CI 0.19-1.60, p=NS). Socioeconomic status was not significantly associated with 30-day mortality (OR 0.55 for most vs least materially deprived) or long-term survival after elective abdominal aortic aneurysm repair.
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