Association of Rurality and Neighborhood Level Socioeconomic Deprivation with Perioperative Health Status in Total Joint Arthroplasty Patients: Analysis from a Large, Tertiary Care Hospital.
J Arthroplasty
; 37(8): 1505-1513, 2022 08.
Article
em En
| MEDLINE
| ID: mdl-35337946
ABSTRACT
BACKGROUND:
Individual socioeconomic status (SES) is associated with disparities in access to care and worse outcomes in total joint arthroplasty (TJA). Neighborhood-level SES measures are sometimes used as a proxy for individual-level SES, but the validity of this approach is unknown. We examined neighborhood level SES and rurality on perioperative health status in TJA.METHODS:
The study population comprised 46,828 TJA surgeries performed at a tertiary care hospital. Community area deprivation index (ADI) was derived from the 2015 American Census Survey. Logistic regression was used to examine perioperative characteristics by ADI and rurality.RESULTS:
Compared to patients from the least deprived neighborhoods, patients from the most deprived neighborhoods were likely to be female (odds ratioOR 1.46, 95% confidence interval CI 1.33-1.61), non-white (OR 1.36, 95% CI 1.13-1.64), with education high school or less (OR 4.85, 95% CI 4.35-5.41), be current smokers (OR 2.20, 95% CI 1.61-2.49), have BMI>30 kg/m2 (OR 1.43, 95% CI 1.30-1.57), more limitation on instrumental activities of daily living (OR 1.75, 95% CI 1.55-1.97) and American Society of Anesthesiologists (ASA) score > II (OR 2.0, 95% CI 1.11-1.37). There was a progressive association between the degree of area level deprivation with preexisting comorbidities. Patients from rural communities were more likely to be male, white, have body mass index (BMI)>30 kg/m2 and lower education levels. However, rurality was either not associated or negatively associated with comorbidities.CONCLUSION:
TJA patients from lower SES neighborhoods have worse behavioral risk factors and higher comorbidity burden than patients from higher SES neighborhoods. Patients from rural communities have worse behavioral risk factors but not comorbidities.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
População Rural
/
Atividades Cotidianas
Tipo de estudo:
Risk_factors_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
J Arthroplasty
Assunto da revista:
ORTOPEDIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Mongólia