Social vulnerability index (SVI) and poor postoperative outcomes in children undergoing surgery in California

Yap, Ava; Laverde, Ruth; Thompson, Avery; Ozgediz, Doruk; Ehie, Odinakachukwu; Mpody, Christian; Vu, Lan

doi:10.1016/j.amjsurg.2022.09.030

Cited by 16 publications

(8 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[29][30][31][32][33][34][35][36][37][38][39][45][46][47] Although the link between SDOH and surgical outcomes has recently been described in pediatric surgery, it has yet to be fully explored in pediatric otolaryngology. 40 Furthermore, a patient's environment may be just as important, if not more, for optimal surgical outcomes. 17,19,43 Previous research has shown that living in disenfranchised neighborhood is associated with a wide range of negative health, developmental, psychosocial, and behavioral outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…In the United States, unfavorable SDOH is linked to delayed access to health care, an increased rate of complications and readmissions, an increased incidence of urgent surgery or length of stay, higher unplanned birth rates, and even lower survival rates 29–39,45–47 . Although the link between SDOH and surgical outcomes has recently been described in pediatric surgery, it has yet to be fully explored in pediatric otolaryngology 40 . Furthermore, a patient's environment may be just as important, if not more, for optimal surgical outcomes 17,19,43 .…”

Section: Discussionmentioning

confidence: 99%

“…[29][30][31][32][33][34][35][36][37][38][39] Furthermore, serious postoperative complications following pediatric general surgery have been demonstrated from a retrospective cohort study employing the National Surgical Quality Improvement Program database. 40 However, no study has thoroughly examined the impact of neighborhood-level factors, as measured by the SVI, on complications or readmissions in patients following T&A.…”

Section: Introductionmentioning

confidence: 99%

“…In the adult population, a high SVI is associated with higher complication rates, residual disability, postoperative mortality, and overall poorer surgical outcomes 29–39 . Furthermore, serious postoperative complications following pediatric general surgery have been demonstrated from a retrospective cohort study employing the National Surgical Quality Improvement Program database 40 . However, no study has thoroughly examined the impact of neighborhood‐level factors, as measured by the SVI, on complications or readmissions in patients following T&A.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Associations Between Social Vulnerability Indicators and Pediatric Tonsillectomy Outcomes

Nieri,

Davies,

Luttrell

et al. 2023

The Laryngoscope

View full text Add to dashboard Cite

ObjectiveTo investigate the impact of neighborhood‐level social vulnerability on pediatric tonsillectomy outcomes.MethodsThis single‐center retrospective cohort study included tonsillectomies performed on children aged 1 to 18 between August 2019 and August 2020. Geographic information systems were used to geocode addresses, and spatial overlays were used to assign census‐tract level social vulnerability index (SVI) scores to each patient. For categorical variables, two‐sided Pearson chi‐square tests were used, whereas for continuous variables, paired t‐tests, means, and standard deviations were calculated. SVI and its four subthemes were investigated using binomial logistic regressions to determine their impact on post‐T&A complications and readmissions.ResultsThe study included 397 patients, with 52 having complications (13.1%) and 33 (8.3%) requiring readmissions due to their complications. Controlling for age, gender, race, insurance status, surgical indication, comorbidities, obesity, and obstructive sleep apnea, postoperative complications were associated with high overall SVI (odds ratio [OR] 5.086, 95% confidence interval [CI] 1.128–22.938), high socioeconomic vulnerability (SVI theme 1, OR 6.003, 95% CI 1.270–28.385), and high house composition vulnerability (SVI theme 2, OR 6.340, 95% CI 1.275–31.525). Readmissions were also associated with high overall SVI (10.149, 95% CI 1.293–79.647) and high housing/transportation vulnerability (SVI theme 4, OR 5.657, 95% CI 1.089–29.396).ConclusionSocial vulnerability at the neighborhood level is linked to poorer surgical outcomes in otherwise healthy children, suggesting a target for community‐based interventions. Because of the increased risk, it may have implications for preoperative decision‐making, treatment plans, and clinic follow‐ups.Level of evidenceIII. Laryngoscope, 2023

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Associations Between Social Vulnerability Indicators and Pediatric Tonsillectomy Outcomes

Nieri,

Davies,

Luttrell

et al. 2023

The Laryngoscope

View full text Add to dashboard Cite

show abstract

“…This value was based on the relationship between each theme and the overall SVI with the predicted number of hospices which found an inflection pointindicating a change in the slope of the predicted value, at the 80 th percentile in the full sample containing all tracts and the analytic restricted to only tracts with hospice agencies. 42 Covariates. Potential confounders were included as covariates.…”

Section: Measurementmentioning

confidence: 99%

Association of Hospice Agency Location and Neighborhood Socioeconomic Disadvantage in the U.S.

Osakwe,

Calixte,

Peterson

et al. 2023

Am J Hosp Palliat Care

View full text Add to dashboard Cite

Background Despite the growing increase in the utilization of hospice in the U.S, disparities exist in the utilization of hospice. Accumulating evidence has shown that neighborhood characteristics have an impact on availability of hospice agencies. Objective To assess the association between neighborhood social vulnerability and hospice agency availability. Methods Using the Medicare Post-Acute Care and Hospice Provider Utilization and Payment Public Use Files (PAC PUF) for 2019. Hospice agency addresses were geocoded to the census tract level. Multivariable Poisson regression models were used to assess the association between socioeconomic status SVI theme and hospice agency availability adjusting for number of home health agencies, primary care health profession shortage, per cent Black, and Percent Hispanic at the census tract level and rurality. Results The socioeconomic status SVI subtheme was associated with decreased likelihood of hospice agency availability (adjusted IRR (aIRR), .56; 95% CI, .50- .63; P < .001). Predominantly Black, and predominantly Hispanic neighborhoods had lower rates of hospice agency availability (aIRR, .48; 95% CI, .39-.59; P < .001 and aIRR, .29; 95% CI, .24-.36; P < .001), respectively. Conclusion Neighborhood socioeconomic disadvantage was associated with lower availability of hospice agencies. Policies aimed at increasing access to hospice should be cognizant of neighborhood socioeconomic disadvantage.

show abstract

Evaluating the Influence of Social Determinants of Health on Blood Phenylalanine Levels in Phenylketonuria Patients

Afseth,

Knutsen,

Lamborn

et al. 2024

American J of Med Genetics Pt A

View full text Add to dashboard Cite

Phenylketonuria (PKU) is a genetic metabolic disorder that causes the accumulation of phenylalanine (Phe) in tissues, leading to intellectual disability, seizures, and socioemotional challenges. The role of social determinants of health (SDOH) in PKU management has not been formally studied, and this investigation evaluates the association between in‐home and in‐office factors on blood Phe levels in PKU patients. We conducted a retrospective chart review on over 200 patients attending the well‐resourced PKU Clinic at Lurie Children's Hospital of Chicago. Data included patients' average Phe level, various demographic information, and CDC/ATSDR social vulnerability index (SVI) score. The analysis revealed no significant association between social vulnerability status and average Phe level. However, a significant correlation was found between sapropterin dihydrochloride use and average Phe level. Age interacted separately with sex assigned at birth, pegvaliase use, total Phe samples submitted, and the presence of genetic testing to significantly influence the average Phe level. This study highlights the multifactorial influences on PKU management and underscores the importance of social resources, such as clinic social workers and state‐provided formula, in modulating the effects of SDOH on PKU control. Further research in different healthcare settings is needed to understand the social determinants affecting PKU patients comprehensively, which will strengthen advocacy efforts for this population.

show abstract

Social vulnerability index (SVI) and poor postoperative outcomes in children undergoing surgery in California

Cited by 16 publications

References 47 publications

Associations Between Social Vulnerability Indicators and Pediatric Tonsillectomy Outcomes

Associations Between Social Vulnerability Indicators and Pediatric Tonsillectomy Outcomes

Association of Hospice Agency Location and Neighborhood Socioeconomic Disadvantage in the U.S.

Evaluating the Influence of Social Determinants of Health on Blood Phenylalanine Levels in Phenylketonuria Patients

Contact Info

Product

Resources

About