Socio-economic factors and rural-urban differences in patients undergoing emergency laparotomy
Pouke, Anne; Ylimartimo, Aura; Nurkkala, Juho; Lahtinen, Sanna; Koskela, Marjo; Vakkala, Merja; Kaakinen, Timo; Raatiniemi, Lasse; Liisanantti, Janne (2024-08-22)
Lippincott
22.08.2024
Pouke, A., Ylimartimo, A., Nurkkala, J., Lahtinen, S., Koskela, M., Vakkala, M., Kaakinen, T., Raatiniemi, L., & Liisanantti, J. (2024). Socio-economic factors and rural-urban differences in patients undergoing emergency laparotomy. Annals of Medicine & Surgery, 86(10), 5704–5710. https://doi.org/10.1097/MS9.0000000000002498
https://creativecommons.org/licenses/by-nc-nd/4.0/
© 2024 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
https://creativecommons.org/licenses/by-nc-nd/4.0/
© 2024 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
https://creativecommons.org/licenses/by-nc-nd/4.0/
Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202410046173
https://urn.fi/URN:NBN:fi:oulu-202410046173
Tiivistelmä
Abstract
Background:
Emergency laparotomy (EL) is a common surgical procedure with high rates of mortality and complications. Socio-economic circumstances and regional differences have an influence on the utilization of care and outcomes in many diagnostic groups, but there are only a few studies focusing on their effect in EL population. The aim of this study was to examine the socio-economic and regional differences in the rate of EL within one tertiary care hospital district.
Methods:
Retrospective single-center study of 573 patients who underwent EL in Oulu University Hospital between May 2015 and December 2017. The postal code area of each patient’s home address was used to determine the socio-economic status and rurality of the location of residence.
Results:
The age-adjusted rate of EL was higher in patients from low-income areas compared to patients from high-income areas [1.46 ((95% CI 1.27–1.64)) vs. 1.15 (95% CI, 0.96–1.34)]. The rate of EL was higher in rural areas compared to urban areas [1.29 (95% CI 1.17–1.41 vs. 1.42 (1.18–1.67)]. Peritonitis was more common in patients living in low-income areas. There were no differences in operation types or mortality between the groups.
Conclusions:
The study findings suggest that there are socio-economic and regional differences in the need of EL. The patients living in low-income areas had a higher rate of EL and a higher rate of peritonitis. These differences cannot be explained by patient demographics or comorbidities alone.
Background:
Emergency laparotomy (EL) is a common surgical procedure with high rates of mortality and complications. Socio-economic circumstances and regional differences have an influence on the utilization of care and outcomes in many diagnostic groups, but there are only a few studies focusing on their effect in EL population. The aim of this study was to examine the socio-economic and regional differences in the rate of EL within one tertiary care hospital district.
Methods:
Retrospective single-center study of 573 patients who underwent EL in Oulu University Hospital between May 2015 and December 2017. The postal code area of each patient’s home address was used to determine the socio-economic status and rurality of the location of residence.
Results:
The age-adjusted rate of EL was higher in patients from low-income areas compared to patients from high-income areas [1.46 ((95% CI 1.27–1.64)) vs. 1.15 (95% CI, 0.96–1.34)]. The rate of EL was higher in rural areas compared to urban areas [1.29 (95% CI 1.17–1.41 vs. 1.42 (1.18–1.67)]. Peritonitis was more common in patients living in low-income areas. There were no differences in operation types or mortality between the groups.
Conclusions:
The study findings suggest that there are socio-economic and regional differences in the need of EL. The patients living in low-income areas had a higher rate of EL and a higher rate of peritonitis. These differences cannot be explained by patient demographics or comorbidities alone.
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