Social determinants of health and their impact on rates of postoperative complications among patients undergoing vertical sleeve gastrectomy

Social determinants of health and the prediction of 90-day mortality among brain tumor patients

“…[35][36][37] In two recent studies using a methodology similar to that in the present study, 9044 (35.6%) of 25,387 vertical sleeve gastrectomy patients and 9333 (21.3%) of 43,918 single-level lumbar fusion patients were reported to experience at least one SDOH-related disparity based on ICD-9 and ICD-10 codes. 20,21 While the proportions of patients experiencing SDOH-related disparities were greater in those studies than in the present one, our cohort contains a majority of White and privately insured patients, two populations that are expected to be less likely to experience SDOH-related disparities. 38 Nevertheless, given that 68% of Americans may experience unmet social needs over the course of a year, with at least 28% experiencing barriers to health, the content and reporting of ICD-9 and ICD-10 codes must still be improved to accurately represent the true proportion of patients experiencing SDOH-related disparities.…”

“…25 Table 1 displays the International Classification of Diseases Ninth and Tenth Revisions (ICD-9 and ICD-10) codes used to determine whether patients experienced an SDOH-related disparity. 20,21 Demographic and clinical data collected for each patient included the following variables: age, sex, race, ethnicity, marital status, insurance, brain tumor diagnosis, frailty, American Society of Anesthesiologists (ASA) physical status classification, surgery number (i.e., first, second, third, or fourth surgery), hospital LOS, post- 26 A total mFI-5 score ranging from 0 to 5 points was then calculated. ASA classes range from 1 to 6 (in increments of 1), describing patients with localized disease that does not cause systemic disturbance to patients with extreme systemic disorders and a poor physical state.…”

“…21 Patients with at least one SDOH disparity and undergoing vertical sleeve gastrectomy were also more likely to have any postoperative complication (HR 1.20, p = 0.02) and an extended hospital LOS (3.07 vs 1.58 days, p < 0.001) than those without SDOH-related disparities. 20 While recent research has established that the aggregate effect of broadscale SDOHs is as a significant negative prognostic factor in the outcomes of surgeries in various subspecialties, to our knowledge these effects have not been investigated in brain tumor patients specifically. [20][21][22][23] Thus, in the present study, we sought to investigate whether experiencing at least one SDOH disparity independently predicted postoperative outcomes in brain tumor patients.…”

“…20 While recent research has established that the aggregate effect of broadscale SDOHs is as a significant negative prognostic factor in the outcomes of surgeries in various subspecialties, to our knowledge these effects have not been investigated in brain tumor patients specifically. [20][21][22][23] Thus, in the present study, we sought to investigate whether experiencing at least one SDOH disparity independently predicted postoperative outcomes in brain tumor patients.…”

“…12,19 While these findings are important, wider investigations of SDOHs aggregate broadscale disparities encompassing factors such as 1) economic stability, 2) educational access and quality, 3) healthcare access and quality, 4) neighborhood and the built environment, and 5) social and community context; these investigations have only recently been pursued in nonneurosurgical subspecialties. [20][21][22][23] In the present study, we sought to investigate the effects of SDOHs on brain tumor resection outcomes.…”