Evidence map›Paper›PMID 40993004›Full record

Observational studyBritish journal of anaesthesia2025

Social deprivation and morbidity and mortality after surgery: a UK national observational cohort study.

Eimear Lusby, Danny J N Wong, Ruaraidh Campbell, Bo Hou, Snehal Pinto Pereira, SNAP-2: EpiCCS collaborators, Steve K Harris, S Ramani Moonesinghe

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in British journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Eimear LusbyCentre for Research and Improvement, Royal College of Anaesthetists, London, UK; Department of Targeted Intervention, University College London, London, UK. Electronic address: eimhear.lusby@nhs.net.
Danny J N WongDepartment of Anaesthesiology, Singapore General Hospital, Singapore; Department of Surgical and Interventional Engineering, Faculty of Life Sciences & Medicine, King's College London, London, UK.
Ruaraidh CampbellInstitute of Health Informatics, University College London, London, UK.
Bo HouNational Institute for Health Research, Central London Patient Safety Research Collaboration, London, UK.
Snehal Pinto PereiraDepartment of Targeted Intervention, University College London, London, UK.
SNAP-2: EpiCCS collaborators
Steve K HarrisNational Institute for Health Research, University College London Hospitals Biomedical Research Centre, University College, London, UK.
S Ramani MoonesingheNational Institute for Health Research, Central London Patient Safety Research Collaboration, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSocioeconomic deprivation is associated with poor surgical outcomes. We assessed associations between deprivation and postoperative morbidity and mortality in a UK-wide surgical cohort.

methodsWe analysed UK data from the Second Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS), a prospective non-consenting cohort study of adults undergoing elective and emergency inpatient noncardiac surgery. Socioeconomic deprivation was reported using the standardised aggregate scale, Index of Multiple Deprivation (IMD; IMD1: most deprived, IMD5: least deprived). Multivariable mixed effects logistic regression was used to model the association between deprivation and postoperative outcomes, adjusting for potential confounders.

resultsOf the 18 901 patients included, those in more deprived groups were younger, had higher disease prevalence, and had greater illness severity. Morbidity, as measured by the Post-Operative Morbidity Survey, was reported in 13.7% at day 7, and in-hospital 30-day mortality was 1.3%. Adjusting for patient characteristics and surgical factors, the odds ratios (ORs) for morbidity at day 7 were 1.26 (95% confidence interval [95% CI]: 1.09-1.47) for IMD2 and 1.32 (95% CI: 1.13-1.53) for IMD1, compared with IMD5. Mortality risk was also higher: OR 1.75 (95% CI: 1.12-1.73) for IMD2 and OR 1.90 (95% CI: 1.22-2.95) for IMD1. However, after adjusting for markers of preoperative physical status and comorbidities, the association between deprivation and outcomes was attenuated.

conclusionsSocioeconomic deprivation is associated with short-term postoperative morbidity and mortality. This association might relate to poorer baseline fitness among people living in socioeconomically deprived areas, highlighting opportunities for targeted preoperative optimisation.

Indexed as

Postoperative ComplicationsSocial DeprivationAdultAgedCohort StudiesFemaleHospital MortalityHumansMaleMiddle AgedMorbidityProspective StudiesUnited Kingdomhealthcare disparitiesmorbidityperioperative carepostoperative complicationssocioeconomic factorssurgery

Identifiers

PMID40993004
PMCPMC12597322

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