Department of Surgery, University of Colorado, 12631 East 17th Ave., Mail Stop C313, Aurora, CO, 80045, USA.
Surgical Outcomes and Applied Research, University of Colorado Anschutz Medical Campus, 12631 East 17th Ave., Mail Stop C313, Aurora, CO, 80045, USA.
Am J Surg. 2022 Jul;224(1 Pt A):100-105. doi: 10.1016/j.amjsurg.2022.03.010. Epub 2022 Mar 9.
Neighborhood measures of social vulnerability encompassing multiple sociodemographic factors can be used to quantify disparities in outcomes. We hypothesize patients with high Social Vulnerability Index (SVI) are at increased risk of morbidity following colectomy.
We used local 2012-2017 National Surgical Quality Improvement Program (NSQIP) data to study colectomy patients, examining associations between SVI and postoperative outcomes.
We included 976 patients from five hospitals. High SVI (>75th percentile) was associated with increased postoperative morbidity on unadjusted analysis (OR 1.84, 95% CI 1.35-2.52, p < 0.001); this association persisted after adjusting for demographics and comorbidities (OR 1.63, 95% CI 1.15-2.31, p = 0.005). The association with SVI was not significant after adjusting for perioperative risk modifiers such as emergent presentation (OR 1.37, 95% CI 0.95-1.98, p = 0.10).
High social vulnerability is associated with increased postoperative complications. This effect appears mediated by perioperative risk factors, suggesting potential to improve outcomes by facilitating timely surgical intervention.
包含多个社会人口因素的邻里社会脆弱性衡量标准可用于量化结果差异。我们假设社会脆弱性指数（SVI）高的患者在接受结肠切除术后面临更高的发病风险。
我们使用当地 2012 年至 2017 年国家手术质量改进计划（NSQIP）数据研究结肠切除术患者，检查 SVI 与术后结果之间的关联。
我们纳入了来自五家医院的 976 名患者。在未调整分析中，高 SVI（>第 75 个百分位数）与术后发病率增加相关（OR 1.84，95%CI 1.35-2.52，p<0.001）；调整人口统计学和合并症后，这种关联仍然存在（OR 1.63，95%CI 1.15-2.31，p=0.005）。在调整围手术期风险修饰因子（如紧急就诊）后，与 SVI 的关联不显著（OR 1.37，95%CI 0.95-1.98，p=0.10）。
高社会脆弱性与术后并发症增加相关。这种影响似乎是由围手术期风险因素介导的，这表明通过促进及时的手术干预，有可能改善结果。
