Key result
Highest and lowest socioeconomic deprivation are linked to more minor complications and prolonged hospital stays.
Why the study?
Patients from deprived areas often have inferior surgical outcomes, but how outcomes vary by deprivation in elective abdominal wall reconstruction was unknown.
How do surgical outcomes vary by socioeconomic deprivation for patients undergoing elective abdominal wall reconstruction?
Cohort (n=234)
Yes
How do surgical outcomes vary by socioeconomic deprivation for patients undergoing elective abdominal wall reconstruction?
Socioeconomic deprivation is associated with higher minor complication rates and longer hospital stays following elective abdominal wall reconstruction, highlighting the need for equitable patient optimization.
Socioeconomic disparities may affect minor complication rates after abdominal wall reconstruction; this observational link leaves open targeted optimization strategies and prospective confirmation.
PURPOSE: Patients from deprived areas are more likely to experience longer waiting times for elective surgery, be multimorbid, and have inferior outcomes from elective and emergency surgery. This study aims to investigate how surgical outcomes vary by deprivation for patients undergoing elective abdominal wall reconstruction. METHODS: A three-centre retrospective cohort study was conducted across three hospitals in North-West England, including patients with complex ventral hernias undergoing abdominal wall reconstruction between 2013 and 2021. Demographic data, comorbidities, and index of multiple deprivation quintiles were recorded. RESULTS: 234 patients (49.6% female), age 57 (SD 13) years, underwent elective abdominal wall reconstruction. Significantly higher unemployment rates were found in the most deprived quintiles (Q1 and Q2). There were more smokers in Q1 and Q2, but no significant deprivation related differences in BMI, diabetes, chronic kidney disease or ischaemic heart disease. There were also higher rates of Clavien-Dindo 1-2 complications in Q1 and Q5, but no difference in the Clavien-Dindo 3-4 outcomes. Patients in Q1 and Q5 had a significantly greater hospital length of stay. CONCLUSION: The association between deprivation and greater unemployment and smoking rates highlights the potential need for equitable support in patient optimisation. The lack of differences in patient co-morbidities and hernia characteristics could represent the application of standardised operative criteria and thresholds. Further research is needed to better understand the relationship between socioeconomic status, complications, and prolonged hospital length of stay.
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Shrestha et al. (2024) conducted a cohort in Complex ventral hernias (n=234). Socioeconomic deprivation (Index of Multiple Deprivation) vs. Different deprivation quintiles was evaluated on Post-operative complications (IMD Quintile 2 vs Quintile 1) (OR 0.22, 95% CI 0.08-0.61, p=0.003). Socioeconomic deprivation was associated with higher rates of minor complications and prolonged hospital length of stay in the most and least deprived quintiles, despite similar baseline comorbidities.
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