Key result
High social vulnerability linked to ~50% higher odds of 30-day readmission after cardiac surgery.
Why the study?
The impact of neighborhood-level socioeconomic vulnerability on outcomes remains to be elucidated within cardiac surgery.
Does high social vulnerability increase the risk of 30-day readmission in adult patients undergoing cardiac surgery?
Cohort (n=5,704)
Yes
Does high social vulnerability increase the risk of 30-day readmission in adult patients undergoing cardiac surgery?
Odds Ratio: 1.5 (95% CI 1–2.1)
High social vulnerability is associated with a 50% increased odds of 30-day readmission following cardiac surgery, highlighting the importance of incorporating social determinants of health into perioperative risk stratification.
Neighborhood social vulnerability may flag cardiac surgery patients for targeted readmission prevention; hypothesis-generating and requires prospective confirmation.
BACKGROUND: The impact of neighborhood-level socioeconomic vulnerability remains to be elucidated within cardiac surgery. Using a multi-institutional database from a statewide collaborative, we analyzed the association of greater social vulnerability with 30-day readmission. METHODS: The 2018-2023 University of California Cardiac Surgery Consortium database was queried to identify all adult patients (≥18 years) undergoing coronary artery bypass grafting and/or valve procedures. The Haversine formula was applied to compute the distance between patient residence and operating hospital. Structural vulnerability was assessed using the well-validated social vulnerability index. This index was stratified into quartiles, with least vulnerable and most vulnerable groups compared in a pairwise approach. Kaplan-Meier time-to-event analyses and Cox proportional hazard models were used to assess readmission within 30 days. RESULTS: Among 5,704 patients, 680 (12.0%) were most vulnerable and 1,172 (31.2%) were least vulnerable. On average, when compared with least vulnerable patients, most vulnerable patients were similar in age, more often of female sex (33.0 vs 26.8%, P = .001), and Hispanic (39.0 vs 19.4%, P < .001). In addition, such patients traveled greater distances to the index hospital (87.2 ± 326.1 vs 113.7 ± 141.6 km, P < .001). After multivariable adjustment, most vulnerable patients were significantly associated with an increased odds of 30-day readmission (adjusted odds ratio: 1.5, 95% confidence interval: 1.0-2.1) and nonhome discharge (adjusted odds ratio: 1.4, 95% confidence interval: 1.0-2.0). CONCLUSION: A high social vulnerability index appears to be associated with inferior outcomes after cardiac surgery. The incorporation of social vulnerability index into risk stratification may improve perioperative outcomes.
No takes yet. Share an insight, caveat, or question.
Hinks et al. (2025) conducted a cohort in Cardiac surgery (coronary artery bypass grafting and/or valve procedures) (n=5,704). High social vulnerability vs. Low social vulnerability was evaluated on 30-day readmission (OR 1.5, 95% CI 1.0-2.1). High social vulnerability was significantly associated with an increased odds of 30-day readmission (adjusted OR 1.5; 95% CI 1.0-2.1) following cardiac surgery compared to low vulnerability.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: