Are documented social needs associated with more complications and readmissions after heart surgery?

Details

Health-related social needs are well established as important to patient outcomes, but research gaps remain about these relationships at the individual level among patients undergoing cardiac surgery.

This retrospective study used the 2016–2018 Nationwide Readmission Database to evaluate postoperative complications and readmissions among patients undergoing coronary artery bypass grafting, aortic surgery, valve surgery, or a combination. Individual-level social vulnerability was identified through clinical documentation using ICD-10 Z-codes. Six Z-code domains were considered social vulnerabilities: employment, family, housing, psychosocial needs, socioeconomic status, and dependence. The researchers analyzed the data using stratification by social vulnerability status and multivariable logistic regression.

The study included 846,837 patients. Dependence-related needs were the most frequently documented domain. Patients with social vulnerability documented at any point were younger, had longer hospital stays, and had a higher prevalence of coexisting conditions, readmissions, and complications.

For patients with social vulnerability, the odds ratio for complications was 1.12 (1.03–1.22), and the odds ratio for 90-day readmissions was 1.15 (1.03–1.27). Clinically acknowledged social vulnerability at any point was associated with higher odds of complications or readmissions after cardiac surgery.

The authors concluded that Z-codes may help identify nonmedical factors that can affect patient outcomes, but further standardization and assessment are needed.