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Socioeconomic inequalities in patients undergoing abdominal wall reconstruction in the North-West of England, UK: a three-centre retrospective cohort study.
Shrestha, Donna; Bampouras, Theodoros M; Shelton, Clifford L; Slade, Dominic; Subar, Daren A; Gaffney, Christopher J.
Afiliación
  • Shrestha D; Lancaster Medical School, Lancaster University, Lancaster, LA1 4AT, UK. donnashrestha@doctors.org.uk.
  • Bampouras TM; Blackburn Research Innovation Development Group in General Surgery (BRIDGES), Blackburn, UK. donnashrestha@doctors.org.uk.
  • Shelton CL; Lancaster Medical School, Lancaster University, Lancaster, LA1 4AT, UK.
  • Slade D; Blackburn Research Innovation Development Group in General Surgery (BRIDGES), Blackburn, UK.
  • Subar DA; School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
  • Gaffney CJ; Lancaster Medical School, Lancaster University, Lancaster, LA1 4AT, UK.
Hernia ; 2024 Sep 13.
Article en En | MEDLINE | ID: mdl-39269519
ABSTRACT

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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Hernia Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Francia
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Hernia Asunto de la revista: GASTROENTEROLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Francia