社会经济剥夺与术后死亡率：前瞻性收集数据的回顾性分析

BJA open Pub Date : 2025-07-28 DOI:10.1016/j.bjao.2025.100479

Ross Lilley , Jason Woodier , Jennifer Summers , Patrice Forget

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引用次数: 0

摘要

在全球范围内，贫困和不平等现象正在加剧。本研究旨在探讨剥夺与术后死亡率之间的关系。方法回顾性分析2011年至2019年阿伯丁皇家医院外科手术患者的前瞻性数据。描述了这一时期苏格兰多重剥夺指数（SIMD）、性别、种族和护理专业的趋势。采用Cox回归模型确定SIMD五分位数对术后90天死亡率的影响。结果在性别和SIMD方面没有观察到趋势，但某些专业和种族的比例随时间而变化。79708名参与者中有2609人在手术后90天内死亡（粗死亡率为3.3%）。在SIMD五分位数中，性别、年龄、种族和专业存在显著差异。对这些变量进行校正后的Cox回归显示，剥夺程度越高，90天死亡率越高（与参考SIMD 5相比，SIMD 1的风险比为1.594,95%置信区间为1.335-1.905）。结论剥夺与术后90天死亡率相关。在规划围手术期护理时可考虑剥夺程度。

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

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).