Conway, R., Galvin, S., Coveney, S., O'Riordan, D. and Silke, B. (2013) Deprivation as an outcome determinant in emergency medical admissions. QJM: An International Journal of Medicine, 106(3), pp. 245-251. (doi: 10.1093/qjmed/hcs233)
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Abstract
Background: Deprivation in the general population predicts mortality. We have investigated its relevance to an acute medical admission, using a database of all emergency admissions to St James’ Hospital, Dublin, over a ten year period (2002-2011). <p/>Methods: All emergency admissions, based on geocoding of residence, were allocated to a Small Area Health Research Unit (SAHRU) division, with a corresponding deprivation index. We then examined this index as a univariate (unadjusted) and independent (adjusted) predictor of 30-day in-hospital mortality. <p/>Results: The 30-day in-hospital mortality, over the 10 year period was higher, for those in the upper half of the deprivation distribution (9.6% vs 8.6%: p = 0.002). Indeed, there was a stepwise increase in 30-day mortality over the quintiles of deprivation from 7.3% (Quintile 1) to 8.8%, 10.0%, 10.0% and 9.3% respectively. Univariate logistic regression of the deprivation indices (quintiles) against outcome showed an increased risk (p = 0.002) of a 30-day death with OR’s respectively (compared with lowest deprivation quintile) of 1.23 (95% CI 1.07, 1.40), 1.41 (95% CI 1.24, 1.60), 1.41 (95% CI 1.24, 1.61) and 1.30 (95% CI 1.14, 1.48). The deprivation index was an independent predictor of outcome in a model when adjusted for illness severity and co-morbidity. The fully adjusted OR for a 30-day death was increased by 31% (p=0.001) for patients in the upper half of the deprivation index distribution (OR 1.31: 95% CI 1.20, 1.44). <p/>Conclusion: Deprivation independently of co-morbidity or acute illness severity is a powerful outcome predictor in acute medical admissions.
Item Type: | Articles |
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Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Coveney, Dr Seamus |
Authors: | Conway, R., Galvin, S., Coveney, S., O'Riordan, D., and Silke, B. |
College/School: | College of Science and Engineering > School of Geographical and Earth Sciences > Geography |
Journal Name: | QJM: An International Journal of Medicine |
Publisher: | Oxford University Press |
ISSN: | 1460-2725 |
ISSN (Online): | 1460-2393 |
Published Online: | 18 December 2012 |
Copyright Holders: | Copyright © 2012 Oxford University Press |
First Published: | First published in QJM - An International Journal of Medicine 106(3):245-251 |
Publisher Policy: | Reproduced in accordance with the copyright policy of the publisher |
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