Social deprivation increases the risk of death after heart surgery, new research by Birmingham scientists has revealed.
A major study of 40,000 patients by Birmingham University and University Hospitals Birmingham Foundation Trust has shown that patients from poorer social backgrounds had worse survival rates after cardiac surgery.
The results were for both immediately after the operation while recovering in hospital and over the next five years after surgery.
Researchers are now investigating why this is the case and believe diet, lifestyle and the level of access to healthcare may play a part.
Domenico Pagano, who led the team of investigators from University Hospital Birmingham in Edgbaston, said: “This research suggests that the benefits of cardiac surgery are less in patients from a deprived background.
“The challenge is to identify the factors that determine this gap and to address them.”
Mr Pagona said the project saw data on 44,902 patients from the West Midlands and North West analysed, who had received various types of heart surgery from a bypass operation to replacing heart valves, at five different hospitals between 1997 and 2007.
Deprivation for each patient was calculated using a scale compiled for the 2001 census.
Surprise results showed a 2.4 per cent rise in a patient’s risk of dying for each point of increase on the deprivation scale.
The study also clearly showed factors associated with social deprivation – smoking, obesity and diabetes – all had a significant negative impact on whether a patient survived after surgery.
Professor Nick Freemantle, from Birmingham University, added that there was an even stronger relationship between social deprivation and death during the five-year follow up after surgery when 12 per cent of patients passed away.
“The relationship between deprivation and mortality was pronounced, but this study raises concerns that the effect of proven healthcare interventions may not be equally distributed across socioeconomic boundaries,” said Mr Freemantle.
“This study does highlight the paramount importance of developing rehabilitation programmes both before and after heart surgery which could include aggressive smoking cessation, nutritional and behavioural support to try to reduce these health inequalities.”
The research was only possible because of extensive data collected after cardiac surgery over the past ten years in the United Kingdom by organisations such as the Birmingham and North West of England Cardiac Surgical Centres and the Quality and Outcomes Research Unit (QuORU).
Daniel Ray, director of informatics from the QuORU, said the research showed the importance of collecting healthcare data.
“This may further help in identifying problems and informing healthcare policy,” said Mr Ray.