Highlights
- •Neighborhood-level socioeconomic disadvantage is linked to worse health outcomes.
- •Area Deprivation Index is a validated measure of neighborhood disadvantage.
- •Children from high ADI neighborhoods experience increased postoperative morbidity.
Abstract
Introduction
The impact of socioeconomic status on surgical outcomes has not been well-studied
in children. Area Deprivation Index (ADI) is a validated measure of neighborhood-level
socioeconomic disadvantage.
Methods
A retrospective analysis of surgical patients ages 0–21 years was performed at a quaternary
pediatric hospital from 1/1/2016-12/31/2020. Logistic regression was used to assess
the relationship between ADI, 30-day postoperative mortality and serious adverse events
(SAE).
Results
Among 56,655 patients, the incidence of 30-day mortality and SAE were 0.3% and 8.9%.
On univariable regression, patients from higher state ADI neighborhoods had increased
odds of 30-day postoperative mortality and SAE. After controlling for covariates,
patients from a neighborhood with state ADI ranks of 9 and 10 had 24% (95% CI: 1.06–1.45)
and 27% (95% CI: 1.08–1.49) increased odds of experiencing SAE.
Discussion
Pediatric surgical patients from disadvantaged neighborhoods may experience worse
postoperative outcomes irrespective of patient demographics and preoperative health
status.
Keywords
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Article info
Publication history
Published online: February 04, 2023
Accepted:
February 2,
2023
Received in revised form:
January 13,
2023
Received:
November 25,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
