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Influence of socioeconomic status on survival after primary aortic or mitral valve replacement

J P Bagger1, M-B Edwards, K M Taylor

  • 1United Kingdom Heart Valve Registry, Cardiothoracic Directorate, Hammersmith Hospital, London, UK. p.bagger@ic.ac.uk

Heart (British Cardiac Society)
|May 8, 2007
PubMed

Insights

Socioeconomic status impacts long-term survival after aortic or mitral valve replacement. Patients from less deprived areas experienced better long-term outcomes, particularly women.

Area of Science:

  • Cardiovascular Surgery
  • Public Health
  • Health Outcomes Research

Background:

  • Socioeconomic status (SES) is a known determinant of health, but its specific impact on outcomes following major cardiac surgery like valve replacement requires detailed investigation.
  • Understanding these disparities is crucial for developing targeted interventions and improving equitable healthcare delivery.

Purpose of the Study:

  • To investigate the association between socioeconomic status and patient outcomes after first-time aortic or mitral valve replacement.
  • To determine if social deprivation influences short-term and long-term survival rates in this patient population.

Main Methods:

  • Analysis of data from the United Kingdom (UK) Heart Valve Registry, including 51,844 patients undergoing primary aortic or mitral valve replacement between 1986 and 2001.
  • Stratification of patients based on the Carstairs deprivation score, derived from 1991 UK Census data linked to patient postcodes.
  • Evaluation of 30-day, 1-year, and long-term (up to 15 years) survival rates across different socioeconomic levels.

Main Results:

  • Short-term (30-day and 1-year) survival rates were comparable across all socioeconomic groups.
  • Long-term survival was significantly higher in the least deprived socioeconomic group compared to the most deprived groups.
  • Women in the most deprived socioeconomic levels had an 18% lower survival rate than those in the least deprived level; men showed a 7% lower survival rate.

Conclusions:

  • Disadvantaged socioeconomic background negatively affects long-term survival following aortic or mitral valve replacement.
  • The disparity in long-term outcomes is particularly pronounced among women, highlighting gender-specific vulnerabilities related to social deprivation.
  • Factors associated with long-term mortality included biological valves, mitral valve position, female gender, and lower socioeconomic status.
Abstract

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