Socioeconomic deprivation and postoperative mortality::  a retrospective analysis of prospectively collected data

Ross Lilley; Jason Woodier; Jennifer Summers; Patrice Forget

doi:10.1016/j.bjao.2025.100479

Socioeconomic deprivation and postoperative mortality: a retrospective analysis of prospectively collected data

Ross Lilley
, Jason Woodier
, Jennifer Summers
, Patrice Forget

Research output: Contribution to journal › Article › peer-review

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Abstract

Background
Deprivation and inequality are globally increasing. This study aims to explore the relationship between deprivation and postoperative mortality.

Methods
A retrospective analysis was conducted using prospectively collected data from all Aberdeen Royal Infirmary surgical patients from 2011 to 2019. Trends in Scottish Index of Multiple Deprivation (SIMD), sex, ethnicity, and speciality of care over the period were described. A Cox regression model was used to determine the effect of SIMD quintiles on 90-day postoperative mortality.

Results
No trends were observed in sex and SIMD, but proportions of certain specialities and ethnicities changed over time. A total of 2609 of 79 708 participants died within 90 days of their operation (crude mortality of 3.3%). There were significant differences in sex, age, ethnicity, and speciality across SIMD quintiles. Cox regression, adjusted for these variables, revealed that a greater level of deprivation was associated with greater mortality at 90 days (hazard ratio 1.594, 95% confidence interval 1.335–1.905 for SIMD 1 compared with SIMD 5 reference).

Conclusions
Deprivation is associated with 90-day postoperative mortality. The level of deprivation may be considered when planning perioperative care.

Original language	English
Article number	100479
Number of pages	9
Journal	BJA Open
Volume	15
Early online date	28 Jul 2025
DOIs	https://doi.org/10.1016/j.bjao.2025.100479
Publication status	Published - Sept 2025

Bibliographical note

Acknowledgements
The authors thank Susan Jensen (NHS Grampian) for her help in this project.

Keywords

deprivation
mortality
surgery

Access to Document

10.1016/j.bjao.2025.100479Licence: CC BY-NC-ND

Lilley_Etal_BJA_Socioeconomic_Deprivation_and_VOR
© 2025 The Authors. Published by Elsevier Ltd on behalf of British Journal of Anaesthesia. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
Final published version, 633 KBLicence: CC BY-NC-ND

Cite this

@article{adbb4079c52247689dc249768eaa8d3f,

title = "Socioeconomic deprivation and postoperative mortality:: a retrospective analysis of prospectively collected data",

abstract = "Background Deprivation and inequality are globally increasing. This study aims to explore the relationship between deprivation and postoperative mortality. Methods A retrospective analysis was conducted using prospectively collected data from all Aberdeen Royal Infirmary surgical patients from 2011 to 2019. Trends in Scottish Index of Multiple Deprivation (SIMD), sex, ethnicity, and speciality of care over the period were described. A Cox regression model was used to determine the effect of SIMD quintiles on 90-day postoperative mortality. Results No trends were observed in sex and SIMD, but proportions of certain specialities and ethnicities changed over time. A total of 2609 of 79 708 participants died within 90 days of their operation (crude mortality of 3.3\%). There were significant differences in sex, age, ethnicity, and speciality across SIMD quintiles. Cox regression, adjusted for these variables, revealed that a greater level of deprivation was associated with greater mortality at 90 days (hazard ratio 1.594, 95\% confidence interval 1.335–1.905 for SIMD 1 compared with SIMD 5 reference). Conclusions Deprivation is associated with 90-day postoperative mortality. The level of deprivation may be considered when planning perioperative care.",

keywords = "deprivation, mortality, surgery",

author = "Ross Lilley and Jason Woodier and Jennifer Summers and Patrice Forget",

note = "Acknowledgements The authors thank Susan Jensen (NHS Grampian) for her help in this project.",

year = "2025",

month = sep,

doi = "10.1016/j.bjao.2025.100479",

language = "English",

volume = "15",

journal = "BJA Open",

issn = "2772-6096",

publisher = "Elsevier",

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TY - JOUR

T1 - Socioeconomic deprivation and postoperative mortality:

T2 - a retrospective analysis of prospectively collected data

AU - Lilley, Ross

AU - Woodier, Jason

AU - Summers, Jennifer

AU - Forget, Patrice

N1 - Acknowledgements The authors thank Susan Jensen (NHS Grampian) for her help in this project.

PY - 2025/9

Y1 - 2025/9

N2 - Background Deprivation and inequality are globally increasing. This study aims to explore the relationship between deprivation and postoperative mortality. Methods A retrospective analysis was conducted using prospectively collected data from all Aberdeen Royal Infirmary surgical patients from 2011 to 2019. Trends in Scottish Index of Multiple Deprivation (SIMD), sex, ethnicity, and speciality of care over the period were described. A Cox regression model was used to determine the effect of SIMD quintiles on 90-day postoperative mortality. Results No trends were observed in sex and SIMD, but proportions of certain specialities and ethnicities changed over time. A total of 2609 of 79 708 participants died within 90 days of their operation (crude mortality of 3.3%). There were significant differences in sex, age, ethnicity, and speciality across SIMD quintiles. Cox regression, adjusted for these variables, revealed that a greater level of deprivation was associated with greater mortality at 90 days (hazard ratio 1.594, 95% confidence interval 1.335–1.905 for SIMD 1 compared with SIMD 5 reference). Conclusions Deprivation is associated with 90-day postoperative mortality. The level of deprivation may be considered when planning perioperative care.

AB - Background Deprivation and inequality are globally increasing. This study aims to explore the relationship between deprivation and postoperative mortality. Methods A retrospective analysis was conducted using prospectively collected data from all Aberdeen Royal Infirmary surgical patients from 2011 to 2019. Trends in Scottish Index of Multiple Deprivation (SIMD), sex, ethnicity, and speciality of care over the period were described. A Cox regression model was used to determine the effect of SIMD quintiles on 90-day postoperative mortality. Results No trends were observed in sex and SIMD, but proportions of certain specialities and ethnicities changed over time. A total of 2609 of 79 708 participants died within 90 days of their operation (crude mortality of 3.3%). There were significant differences in sex, age, ethnicity, and speciality across SIMD quintiles. Cox regression, adjusted for these variables, revealed that a greater level of deprivation was associated with greater mortality at 90 days (hazard ratio 1.594, 95% confidence interval 1.335–1.905 for SIMD 1 compared with SIMD 5 reference). Conclusions Deprivation is associated with 90-day postoperative mortality. The level of deprivation may be considered when planning perioperative care.

KW - deprivation

KW - mortality

KW - surgery

U2 - 10.1016/j.bjao.2025.100479

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SN - 2772-6096

VL - 15

JO - BJA Open

JF - BJA Open

M1 - 100479

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