Social vulnerability and surgery outcomes: a cross-sectional analysis.

Area of Science:

• Public Health
• Socioeconomic Determinants of Health
• Surgical Outcomes Research

Background:

• Postoperative complications pose unpredictable challenges to healthcare systems.
• Social determinants of health, like socioeconomic conditions, influence health outcomes but their specific impact on surgical complications remains unclear.
• Understanding the heterogeneity of these impacts across different populations and surgical services is crucial for public health policy.

Purpose of the Study:

• To analyze the association between social vulnerability and the incidence of various post-surgical complications.
• To investigate the role of socioeconomic status and housing conditions as contributors to postsurgical outcomes.
• To explore the interaction between social vulnerability and sex/gender in relation to surgical complications.

Main Methods:

• A large-scale, cross-sectional analysis using electronic health records from over 50,000 surgeries (2012-2018).
• Data collected from a quaternary health center in St. Louis, Missouri, including patient zip codes.
• Statistical logistic regression models were employed, incorporating social vulnerability index and sex/race interactions.

Main Results:

• Significant geographic disparities in social vulnerability were observed within the St. Louis area.
• Social vulnerability was associated with abnormal heart rhythm, primarily driven by socioeconomic and housing status.
• Interactions between social vulnerability and female sex showed associations with increased odds of heart attack and surgical wound infection, which diminished after controlling for comorbidities.

Conclusions:

• Social vulnerability indicators, such as socioeconomic status and housing, may impact postsurgical outcomes by influencing preoperative health.
• Prioritizing social vulnerability in preventive medicine and public health strategies is essential for improving surgical patient outcomes.
• These findings highlight the need for integrated approaches to address social determinants for better surgical care.