Maheswaran, R. orcid.org/0000-0002-3899-4421, Tong, T. orcid.org/0000-0002-9307-6850, Michaels, J. orcid.org/0000-0002-3422-7102 et al. (3 more authors) (2022) Socioeconomic disparities in abdominal aortic aneurysm repair rates and survival. British Journal of Surgery, 109 (10). pp. 958-967. ISSN 0007-1323
Abstract
Background Abdominal aortic aneurysm (AAA) is more prevalent in socioeconomically disadvantaged areas. This study investigated socioeconomic disparities in AAA repair rates and survival.
Methods The study used ecological and cohort study designs, from 31 672 census areas in England (April 2006 to March 2018), the Index of Multiple Deprivation 2010 as the area-level deprivation indicator, and Poisson, logistic and Cox regression.
Results Some 77 606 patients (83.4 per cent men) in four age categories (55–64, 65–74, 75–84, 85 or more years) were admitted with AAA from a population aged at least 55 years of 14.7 million. Elective open and endovascular repair rates were 41 (95 per cent c.i. 23 to 61) and 60 (36 to 89) per cent higher respectively among men aged 55–64 years in the most versus least deprived areas by quintile. This differences diminished and appeared to reverse with increasing age, with 26 (−1 to 45) and 25 (13 to 35) per cent lower rates respectively in men aged 85 years or more in the most deprived areas. Men admitted from more deprived areas were more likely to die in hospital without aneurysm repair. Among those who had aneurysm repair, this was more likely to be for a ruptured aneurysm than among men from less deprived areas. For intact aneurysm repair, they were relatively more likely to have this during an emergency admission. The mortality rate after repair was higher for men from more deprived areas, although the hazard diminished with age. Patterns were unclear for women.
Conclusion There were clear socioeconomic disparities in operation rates, mode of presentation, and outcome for AAA surgery. Policies are needed to address these disparities.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Aged, 80 and over; Aortic Aneurysm, Abdominal; Aortic Rupture; Cohort Studies; Elective Surgical Procedures; Endovascular Procedures; Female; Humans; Male; Retrospective Studies; Socioeconomic Factors; Treatment Outcome; Vascular Surgical Procedures |
Dates: |
|
Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health The University of Sheffield > Faculty of Social Sciences (Sheffield) > Department of Landscape Architecture (Sheffield) |
Funding Information: | Funder Grant number NATIONAL INSTITUTE FOR HEALTH RESEARCH UNSPECIFIED DEPARTMENT OF HEALTH AND SOCIAL CARE UNSPECIFIED NATIONAL INSTITUTE FOR HEALTH RESEARCH UNSPECIFIED NATIONAL INSTITUTE FOR HEALTH RESEARCH UNSPECIFIED NATIONAL INSTITUTE FOR HEALTH RESEARCH NIHR VASCUALAR SERV DEPARTMENT OF HEALTH AND SOCIAL CARE NIHR202042 National Institute for Health and Care Research RP-PG-1210-12009 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 09 Jan 2024 16:41 |
Last Modified: | 09 Jan 2024 16:41 |
Published Version: | http://dx.doi.org/10.1093/bjs/znac222 |
Status: | Published |
Publisher: | Oxford University Press (OUP) |
Refereed: | Yes |
Identification Number: | 10.1093/bjs/znac222 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:207417 |