Lilley Ross, Woodier Jason, Summers Jennifer, Forget Patrice
Aberdeen Centre for Arthritis and Musculoskeletal Health (Epidemiology group), Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Foresterhill Health Campus, Aberdeen, UK.
Queen Elizabeth Hospital, Gateshead, Tyne and Wear, UK.
BJA Open. 2025 Jul 28;15:100479. doi: 10.1016/j.bjao.2025.100479. eCollection 2025 Sep.
Deprivation and inequality are globally increasing. This study aims to explore the relationship between deprivation and postoperative mortality.
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.
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).
Deprivation is associated with 90-day postoperative mortality. The level of deprivation may be considered when planning perioperative care.
贫困和不平等现象在全球范围内日益加剧。本研究旨在探讨贫困与术后死亡率之间的关系。
采用回顾性分析方法，使用前瞻性收集的2011年至2019年阿伯丁皇家医院所有外科患者的数据。描述了该时期苏格兰多重贫困指数（SIMD）、性别、种族和护理专业的趋势。使用Cox回归模型确定SIMD五分位数对术后90天死亡率的影响。
未观察到性别和SIMD的趋势，但某些专业和种族的比例随时间发生了变化。79708名参与者中共有2609人在术后90天内死亡（粗死亡率为3.3%）。SIMD五分位数在性别、年龄、种族和专业方面存在显著差异。对这些变量进行调整后的Cox回归显示，贫困程度越高，90天时的死亡率越高（与SIMD 5作为参照相比，SIMD 1的风险比为1.594，95%置信区间为1.335-1.905）。
贫困与术后90天死亡率相关。在规划围手术期护理时可考虑贫困程度。
