Influence of Socioeconomic Deprivation on Surgical Outcomes for Patients With Sigmoid Diverticulitis in France

被引:0
作者
Alves, Arnaud [1 ,2 ]
Sabbagh, Charles [3 ]
Ouaissi, Mehdi [4 ]
Zerbib, Philippe [5 ]
Bridoux, Valerie [6 ]
Manceau, Gilles [7 ]
Panis, Yves [8 ]
Buscail, Etienne [9 ]
Venara, Aurelien [10 ]
Khaoudy, Iman [11 ]
Gaillard, Martin [12 ]
Viennet, Manon [13 ]
Thobie, Alexandre [14 ]
Menahem, Benjamin [4 ]
Eveno, Clarisse [15 ]
Bonnel, Catherine [16 ]
Mabrut, Jean-Yves [17 ]
Badic, Bogdan [18 ]
Godet, Camille [19 ]
Eid, Yassine [20 ]
Duchalais, Emilie [21 ]
Lakkis, Zaher [22 ]
Cotte, Eddy [23 ]
Laforest, Anais [24 ]
Defourneaux, Veronique [25 ]
Maggiori, Leon [26 ]
Rebibo, Lionel [27 ]
Christou, Niki [28 ]
Talal, Ali [29 ]
Mege, Diane [30 ]
Bonnamy, Cecile [31 ]
Germain, Adeline [32 ]
Mauvais, Francois [33 ]
Tresallet, Christophe [34 ]
Roudie, Jean [35 ]
Laurent, Alexis [36 ]
Trilling, Bertrand [37 ]
Bertrand, Martin [38 ]
Massalou, Damien [39 ]
Romain, Benoit [40 ]
Tranchart, Hadrien [41 ]
Pellegrin, Alexandra [3 ]
Beyer-Berjot, Laura [42 ]
Dejardin, Olivier [2 ,43 ]
机构
[1] Univ Hosp Caen, Dept Digest Surg, Caen, France
[2] ANTICIPE Res Unit, Caen, France
[3] Amiens Univ Hosp, Dept Digest Surg, Amiens, France
[4] Univ Hosp Tours, Trousseau Hosp, Dept Digest, Oncol Endocrine Hepatobil & Liver Transplant, Tours, France
[5] Univ Lille Nord France, Huriez Hosp, Dept Digest Surg & Transplantat, Lille, France
[6] Univ Hosp Rouen, Dept Digest Surg, Rouen, France
[7] Georges Pompidou European Hosp, APHP, Dept Surg, Paris, France
[8] Grp Hosp Pr Ambroise Pare Hartmann, Grp Hosp Prive Ambroise Pare Hartmann, Dept Colorectal Surg, Seine, France
[9] Univ Toulouse, CHU Toulouse Rangueil, Dept Digest Surg, Toulouse, France
[10] Univ Hosp Angers, Dept Digest Surg, Angers, France
[11] Le Havre Hosp, Tours, France
[12] Cochin Hosp, Dept Digest Surg, Paris, France
[13] Bocage Univ Hosp, Dept Thorac Surg, F-21000 Dijon, France
[14] Hosp Avranches Granville, Dept Digest Surg, Avranches, France
[15] Univ Hosp Lille, Dept Digest Surg, Lille, France
[16] Grp Hosp Nord Essonne, Serv Anat & Cytol Pathol, Longjumeau, France
[17] Croix Rousse Univ Hosp, Dept Digest Surg & Transplantat, Lyon, France
[18] Univ Hosp, Dept Gen & Digest Surg, Brest, France
[19] Mem Hosp St Lo, Dept Digest Surg, St Lo, France
[20] Hop Robert Bisson, Dept Internal Med, F-14100 Lisieux, France
[21] Univ Hosp Nantes, Dept Oncol Digest & Endocrine Surg, Nantes, France
[22] Univ Hosp Besancon, Dept Digest Surg & Liver Transplantat, Besancon, France
[23] Hop Lyon Sud, Dept Digest Surg, Lyon, France
[24] Inst Mutualiste Montsouris, Dept Digest Surg, Paris, France
[25] CHU Rennes, Dept Digest Surg, Rennes, France
[26] Univ Paris VII, Hop St Louis, AP HP, Dept Digest Surg, Paris, France
[27] Hop Bichat Claude Bernard, Dept Digest Oesogastr & Bariatr Surg, Paris, France
[28] Limoges Hosp, Dept Digest Surg, Limoges, France
[29] Argentan Hosp, Dept Digest Surg, Argentan, France
[30] Timone Univ Hosp, Aix Marseille Univ, APHM, Dept Digest Surg, Marseille, France
[31] Bayeux Hosp, Dept Digest Surg, Bayeux, France
[32] CHRU Nancy, Dept Digest Surg, Nancy, France
[33] Beauvais Hosp, Dept Digest Surg, Beauvais, France
[34] Sorbonne Paris Nord Univ, Avicenne Univ Hosp, Dept Digest Surg Oncol, Bobigny, Paris, France
[35] Martinique Hosp, Dept Digest Surg, Ft Defrance, France
[36] Intercommunal Hosp Creteil, Dept Digest Surg, Creteil, France
[37] Grenoble Alpes Univ Hosp, Dept Digest & Emergency Surg, Grenoble, France
[38] Univ Hosp Nimes, Dept Digest Surg, Nimes, France
[39] Nice Univ, Hop LArchet, Dept Digest Surg, Nice, France
[40] Strasbourg Univ Hosp, Hautepierre Hosp, Dept Gen & Digest Surg, Strasbourg, France
[41] Antoine Beclere Hosp, APHP, Dept Minimally Invas Digest Surg, Clamart, France
[42] North Univ Hosp, AP HM, Dept Digest Surg, Marseille, France
[43] CHU Caen, Dept Res, Caen, France
关键词
deprivation; diverticulitis; sigmoid; socioeconomic status; surgical outcomes; INSURANCE STATUS; MORTALITY; INDEX; RACE; MORBIDITY; COLECTOMY; RESECTION; COHORT; HEALTH;
D O I
10.1097/SLA.0000000000006497
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objectives:To evaluate the relationship between socioeconomic deprivation and postoperative outcomes in patients who underwent colonic resection for sigmoid diverticulitis (SD).Background:The potential impact of socioeconomic inequalities on the management of SD has been scarcely studied in the literature. Considering other gastrointestinal pathologies for which lesser access to optimal treatment and poorer survival have been shown, we hypothesize that deprivation could be associated with outcomes for SD.Methods:This multicenter retrospective study was conducted at 41 French hospitals between January 1, 2010, and August 31, 2021. The main outcome was the occurrence of severe postoperative complications on postoperative day 90, according to the Clavien-Dindo scale (>= 3). The European Deprivation Index was used to approximate deprivation for each patient. Multiple imputations by a chained equation were performed to consider the influence of missing data on the results.Results:Twenty percent of the 6415 patients operated on had severe postoperative complications at 90 days. In the multivariate regression analysis, increasing age, male sex, American Society of Anesthesiologists score >= 3, conversion to laparotomy or upfront open approach, surgical procedures, and perioperative transfusion were independent risk factors for severe postoperative complications. After adjusting for age, sex, body mass index, American Society of Anesthesiologists score, emergent setting, blood transfusion, indications for surgery, surgical approach, and procedures, the probability of severe postoperative complications increased with socioeconomic deprivation (P=0.026) by day 90.Conclusions:This study highlights the potential influence of socioeconomic deprivation on the surgical outcomes of SD. Socioeconomic deprivation should be considered as a risk factor for severe postoperative complications during the preoperative assessment of the patient's medical conditions.
引用
收藏
页码:858 / 869
页数:12
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