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Social Deprivation Impairs Cardiac Surgery Prognosis

Smoking, diabetes, extreme body mass index cause worse prognosis for the poor

FRIDAY, April 3 (HealthDay News) -- Potentially modifiable risk factors that are associated with social deprivation -- such as smoking, extremely high or low body mass index, and diabetes -- adversely affect the outcome of cardiac surgery, according to a report published online April 2 in BMJ.

Domenico Pagano, M.D., of Queen Elizabeth Hospital in Birmingham, U.K., and colleagues analyzed data on 44,902 adults who underwent cardiac surgery at five hospitals in England from 1997 to 2007. The researchers looked at all-cause mortality and assessed social deprivation using census data.

The overall mortality rate for cardiac surgery was 3.25 percent in-hospital and 12.4 percent at mid-term follow-up (median 1,887 days), and patients who lived in conditions of social deprivation had higher odds of mortality, the researchers report. Other risk factors such as smoking and diabetes were associated with social deprivation, but even when these and additional risk factors such as body mass index were taken into account, social deprivation was an independent predictor of mortality, the investigators found.

"Some additional factors related to deprivation might influence outcome," the authors write. "In the face of easy access to effective health care the real challenge lies in developing a coherent health conscious approach to education and to the environment. This is essential to maximize the benefits of expensive and complex health care interventions such as cardiac surgery."

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