Socioeconomic deprivation and postoperative mortality: a retrospective analysis of prospectively collected data

Abstract

Background

Deprivation and inequality are globally increasing. This study aims to explore the relationship between deprivation and postoperative mortality.

Methods

A retrospective analysis was conducted using prospectively collected data from all Aberdeen Royal Infirmary surgical patients from 2011 to 2019. Trends in Scottish Index of Multiple Deprivation (SIMD), sex, ethnicity, and speciality of care over the period were described. A Cox regression model was used to determine the effect of SIMD quintiles on 90-day postoperative mortality.

Results

No trends were observed in sex and SIMD, but proportions of certain specialities and ethnicities changed over time. A total of 2609 of 79 708 participants died within 90 days of their operation (crude mortality of 3.3%). There were significant differences in sex, age, ethnicity, and speciality across SIMD quintiles. Cox regression, adjusted for these variables, revealed that a greater level of deprivation was associated with greater mortality at 90 days (hazard ratio 1.594, 95% confidence interval 1.335–1.905 for SIMD 1 compared with SIMD 5 reference).

Conclusions

Deprivation is associated with 90-day postoperative mortality. The level of deprivation may be considered when planning perioperative care.