TOPLINE

Individuals in more deprived areas had a higher rate of surgery than those in less deprived areas, and had a higher risk of developing new long-term disease after surgery.

METHODOLOGY

• Researchers conducted a longitudinal population study to assess whether surgery was associated with increased risk for long-term disease and whether risks differed by socioeconomic status and ethnicity.
• They analyzed linked primary and secondary care records of more than 18.3 million adults in England (2012-2022). Hospital admission for a surgical procedure was recorded.
• Deprivation was assessed using the Index of Multiple Deprivation in deciles (1 most deprived, 10 least deprived) and ethnicity was also retrieved.
• The outcome was a newly documented long-term disease at 1 and 3 years.

TAKEAWAY

• Overall, 48.8% of individuals underwent surgery (median age, 46 years; 53% women). Of those, 78.6% of surgeries were elective and 21.4% were emergency. 
• Individuals in the most deprived areas had a 1.11-fold higher rate of elective surgery and a 1.54-fold higher rate of emergency surgery compared with those in the least deprived areas. 
• Among individuals who underwent elective surgery, those in the most vs least deprived areas had a 33% higher risk for new long-term disease at 1 year (adjusted hazard ratio [aHR], 1.33; 95% CI, 1.31-1.35) and a 45% higher risk at 3 years (aHR, 1.45; 95% CI, 1.43-1.46). Risks were also higher after emergency surgery.
• Asian and Black patients had surgery less often, had surgery at younger ages, and faced higher risks of developing new long-term disease after elective surgery, compared with White patients.

IN PRACTICE

"[The study] suggests that need for surgery may be an important marker of inequalities in healthy life expectancy and that the perioperative period offers a key opportunity to improve long-term health to reduce further inequalities," the researchers reported.

SOURCE

The study was led by Yize I. Wan, PhD, of Queen Mary University of London, England. It was published online on September 11 in the British Journal of Anaesthesia.

LIMITATIONS

Researchers measured deprivation at area level, not individual level. They could not include individuals without a permanent address or those who were not registered with a general practice. The study was observational and could not establish that surgery caused long-term disease. 

DISCLOSURES

The study received funding from the Barts Charity and the Academy of Medical Sciences. The authors declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.