Social drivers of health and perioperative outcomes: Identifying domains and barriers with significant impact

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2026-06-01 Epub Date: 2026-02-28 DOI:10.1016/j.amjsurg.2026.116890

Michael A. Edwards , Skye Buckner Petty , Kashmira Chawla , Sreya Pattipati , Ryan May , Erin Westfall , Mohanad R. Youssef , Nathan L. Delafield , Jaxon K. Quillen , Adam J. Milam

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引用次数: 0

Abstract

Objectives

This retrospective cohort of patients undergoing surgery from 2019 to 2023 evaluated the association between individual-level social drivers of health (SDoH) and postoperative outcomes (length of stay, 30-day mortality, 30-day readmission).

Methods

Patients from a multi-site health system who completed a SDoH questionnaire were categorized as high-risk or not high-risk across five SDoH domains (e.g., financial resources) and were stratified into 3 surgical cohorts (elective outpatient, inpatient and emergency surgery). Regression models, adjusted for potential confounders, assessed the association between SDoH and postoperative outcomes.

Results

Among 297,723 patients, 74% completed the SDoH questionnaire. High-risk transportation need was associated with higher unplanned 30-day readmission for all cohorts; for elective surgeries, high-risk transportation was also associated with higher mortality. The other SDoH domains were inconsistently associated with postoperative outcomes.

Conclusions

Individual-level SDoH, particularly transportation needs and financial strain, are linked to adverse postoperative surgical outcomes. Systematic SDoH interventions are crucial to addressing healthcare disparities.

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健康和围手术期结果的社会驱动因素：确定具有重大影响的领域和障碍

目的：对2019年至2023年接受手术的患者进行回顾性队列研究，评估个人层面的社会健康驱动因素（SDoH）与术后结果（住院时间、30天死亡率、30天再入院）之间的关系。方法来自多站点卫生系统的患者完成SDoH问卷，在5个SDoH领域（如财政资源）将其分类为高风险或非高风险，并分为3个手术队列（选择性门诊、住院和急诊手术）。校正潜在混杂因素的回归模型评估了SDoH与术后预后之间的关系。结果297,723例患者中，74%的患者完成了SDoH问卷。高风险运输需求与所有队列中较高的计划外30天再入院率相关；对于选择性手术，高风险转运也与较高的死亡率相关。其他SDoH结构域与术后结果的相关性不一致。结论个体水平的SDoH，特别是交通需求和经济压力，与术后不良手术结果有关。系统的SDoH干预措施对于解决保健差距至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.