Health, Economic Factors Tied to Outcomes of Emergency Surgery

Increased levels of comorbidity and socioeconomic deprivation are associated with mortality, discharge destination, and length of hospital stay (LOS) following admission for emergency general surgery (EGS), according to a study published online Aug. 24 in Trauma Surgery & Acute Care Open.

Jared M. Wohlgemut, MBChB, from the University of Aberdeen in the United Kingdom, and colleagues examined the effect of deprivation and comorbidity on mortality, discharge destination, and LOS in adult patients requiring EGS admitted between 1997 and 2016. Data were analyzed for 1,477,810 EGS admissions.

The researchers found that 16.2 and 5.6 percent of the EGS admissions were in the most and least deprived Scottish Index of Multiple Deprivation deciles, respectively. Overall, 75.6, 20.3, 2.5, and 1.6 percent had no comorbidity, mild comorbidity, moderate comorbidity, and severe comorbidity, respectively. A total of 78.6 percent of patients were discharged home directly. Severe comorbidity was associated with not being discharged directly to home and with higher inpatient mortality (odds ratios, 0.38 and 13.74, respectively). Those from the most deprived population were less likely to be discharged directly to home and had higher inpatient mortality compared with the most affluent population (odds ratios, 0.97 and 1.36, respectively). There were associations observed for severe comorbidity and socioeconomic deprivation with longer LOS (odds ratios, 1.69 and 1.11, respectively).

“Increased levels of comorbidity and, to a lesser extent, socioeconomic deprivation significantly affect outcomes of EGS admissions in a free at the point of care health care system,” the authors write.

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