{
  "abstract": "Background Socioeconomic deprivation has been associated with adverse outcomes after aortic surgery, although evidence remains inconsistent. We assessed its impact on postoperative and long-term outcomes after major aortic surgery.Methods We included consecutive patients who underwent type A acute aortic dissection (TAAAD) repair or elective/urgent major aortic surgery between 2004 and 2025 at our institution. Socioeconomic status was determined using the Index of Multiple Deprivation (IMD) and patients were further categorised into most deprived (quintiles 1–3) and least deprived (quintiles 4–5). A secondary analysis evaluated outcomes across all five IMD quintiles. Postoperative outcomes and long-term survival were compared using univariable and multivariable models.Results The TAAAD cohort included 526 patients (median age 64 years; 34% female), with 250 (47.5%) classified as most deprived and 276 (52.5%) as least deprived. In-hospital mortality was significantly higher among the most deprived group (20% vs 12%, p=0.008), with deprivation independently associated with higher in-hospital mortality (OR 2.44, 95% CI 1.20 to 4.96). 10-year survival was also significantly reduced in the most deprived group (56.0% vs 69.4%, p<0.001), and deprivation remained an independent predictor of long-term mortality (HR 1.67, 95% CI 1.22 to 2.28). The elective/urgent cohort comprised 1320 patients (median age 65 years; 32% female), with 696 (52.7%) classified as most deprived and 624 (47.3%) as least deprived. No significant differences were observed between groups in postoperative and long-term outcomes.Conclusions Socioeconomic deprivation independently predicts higher postoperative and long-term mortality in patients undergoing emergency TAAAD repair, whereas no association was observed in the elective/urgent cohort.",
  "authors": [
    {
      "affiliations": [
        "Bristol Heart Institute, University of Bristol, Bristol, UK"
      ],
      "name": "Marco Gemelli"
    },
    {
      "affiliations": [
        "Bristol Heart Institute, University of Bristol, Bristol, UK",
        "Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK"
      ],
      "name": "Lauren K Dixon"
    },
    {
      "affiliations": [
        "Bristol Heart Institute, University of Bristol, Bristol, UK"
      ],
      "name": "Thanakorn Rojanathagoon"
    },
    {
      "affiliations": [
        "Bristol Heart Institute, University of Bristol, Bristol, UK"
      ],
      "name": "Ettorino Di Tommaso"
    },
    {
      "affiliations": [
        "Bristol Heart Institute, University of Bristol, Bristol, UK"
      ],
      "name": "Anilkumar S Annaiah"
    },
    {
      "affiliations": [
        "Bristol Heart Institute, University of Bristol, Bristol, UK"
      ],
      "name": "Daniel P Fudulu"
    },
    {
      "affiliations": [
        "Bristol Heart Institute, University of Bristol, Bristol, UK"
      ],
      "name": "Gianni D Angelini"
    },
    {
      "affiliations": [
        "Bristol Heart Institute, University of Bristol, Bristol, UK"
      ],
      "name": "Eltayeb Mohamed Ahmed"
    },
    {
      "affiliations": [
        "Bristol Heart Institute, University of Bristol, Bristol, UK"
      ],
      "name": "Cha Rajakaruna"
    }
  ],
  "title": "Impact of socioeconomic deprivation on early and long-term outcomes after major aortic surgery: insights from a 20-year single-centre cohort",
  "uid": "b0bc4b59-4363-5b4d-9da7-8a549e39a1cc"
}