The impact of social vulnerability subthemes on postop outco
Social vulnerability is an important driver of disparate surgical outcomes. After adjusting for known patient-level factors, the overall impact of the composite social vulnerability index(SVI) metric on odds to achieve a textbook outcome was lower among White/non-Hispanic patients compared with ethnic/minority patients.

Medicare beneficiaries 65 years or older who underwent one of four operations were identified. Multivariable mixed-effects logistic regression was used to measure the association of four social vulnerability subthemes from the social vulnerability index(SVI) were assessed relative to the likelihood to achieve a textbook outcome(TO). Among 579,846 Medicare beneficiaries, the median age was 74 and most patients were White/non-Hispanic.

--On multivariable analysis, the overall impact of the composite SVI metric on odds to achieve a postoperative TO was lower among White/non-Hispanic patients compared with ethnic/minority patients.

--Increasing vulnerability in the subthemes of socioeconomic status and household composition was associated with a greater likelihood not to achieve a TO among minority patients.

Conclusively, worsening SES and household compositions & disability had a detrimental effect on odds of TO following surgery with the most pronounced effect on non-White minority patients.

The American Journal of Surgery
Source: https://doi.org/10.1016/j.amjsurg.2021.05.014
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