Association between Socioeconomic Status and 30-Day and One-Year All-Cause Mortality after Surgery in South Korea.

Tak Kyu Oh,Kooknam Kim,Jung-Won Hwang,Young-Tae Jeon,Sang-Hwan Do

doi:10.3390/jcm7030052

Tak Kyu Oh, Kooknam Kim + Show 3 more

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https://doi.org/10.3390/jcm7030052

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Abstract

Preoperative socioeconomic status (SES) is associated with outcomes after surgery, although the effect on mortality may vary according to region. This retrospective study evaluated patients who underwent elective surgery at a tertiary hospital from 2011 to 2015 in South Korea. Preoperative SES factors (education, religion, marital status, and occupation) were evaluated for their association with 30-day and one-year all-cause mortality. The final analysis included 80,969 patients who were ≥30 years old, with 30-day mortality detected in 339 cases (0.4%) and one-year mortality detected in 2687 cases (3.3%). As compared to never-married patients, those who were married or cohabitating (odds ratio (OR): 0.678, 95% confidence interval (CI): 0.462–0.995) and those divorced or separated (OR: 0.573, 95% CI: 0.359–0.917) had a lower risk of 30-day mortality after surgery. Similarly, the risk of one-year mortality after surgery was lower among married or cohabitating patients (OR: 0.857, 95% CI: 0.746–0.983) than it was for those who had never married. Moreover, as compared to nonreligious patients, Protestant patients had a decreased risk of 30-day mortality after surgery (OR: 0.642, 95% CI: 0.476–0.866). The present study revealed that marital status and religious affiliation are associated with risk of 30-day and one-year all-cause mortality after surgery.

Highlights

Socioeconomic status (SES) encompasses all factors that can affect an individual’s social and economic status, such as education, income, and occupational factors [1]
Age was significantly associated with 30-day mortality after surgery (odds ratio (OR): 1.012, 95%
As compared to never married patients, those who were married or cohabitating (OR: 0.678, 95% confidence interval (CI): 0.462–0.995, P = 0.047) and those divorced or separated (OR: 0.573, 95% CI: 0.359–0.917, P = 0.02) had a lower risk of 30-day mortality after surgery

Summary

Introduction

Socioeconomic status (SES) encompasses all factors that can affect an individual’s social and economic status, such as education, income, and occupational factors [1]. SES is thought to be closely related to health outcomes [2]. Socioeconomic inequality can affect mortality and morbidity, which highlights SES as an important global public health issue [3,4,5]. Postoperative outcomes are affected by various factors, with physiological status being one of the most important [6]. Many studies have examined the effects of physiological factors, few studies have examined the relationship between SES and outcomes after surgery. Some studies have suggested that outcomes after pediatric surgery [7] or hip joint arthroplasty [8]

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