• Arnaud Alves, Charles Sabbagh, Mehdi Ouaissi, Philippe Zerbib, Valérie Bridoux, Gilles Manceau, Yves Panis, Etienne Buscail, Aurélien Venara, Iman Khaoudy, Martin Gaillard, Manon Viennet, Alexandre Thobie, Benjamin Menahem, Clarisse Eveno, Catherine Bonnel, Jean-Yves Mabrut, Bogdan Badic, Camille Godet, Yassine Eid, Emilie Duchalais, Zaher Lakkis, Eddy Cotte, Anaïs Laforest, Véronique Defourneaux, Léon Maggiori, Lionel Rebibo, Niki Christou, Ali Talal, Diane Mege, Cécile Bonnamy, Adeline Germain, François Mauvais, Christophe Tresallet, Jean Roudie, Alexis Laurent, Bertrand Trilling, Martin Bertrand, Damien Massalou, Benoit Romain, Hadrien Tranchart, Alexandra Pellegrin, Laura Beyer-Berjot, Olivier Dejardin, and French Surgical AssociationΦ.
• Department of Digestive Surgery, University of Caen Normandy, Caen, France.
• Ann. Surg. 2024 Nov 1; 280 (5): 858869858-869.

ObjectivesTo evaluate the relationship between socioeconomic deprivation and postoperative outcomes in patients who underwent colonic resection for sigmoid diverticulitis (SD).BackgroundThe potential impact of socioeconomic inequalities on the management of SD has been scarcely studied in the literature. Considering other gastrointestinal pathologies for which lesser access to optimal treatment and poorer survival have been shown, we hypothesize that deprivation could be associated with outcomes for SD.MethodsThis multicenter retrospective study was conducted at 41 French hospitals between January 1, 2010, and August 31, 2021. The main outcome was the occurrence of severe postoperative complications on postoperative day 90, according to the Clavien-Dindo scale (≥3). The European Deprivation Index was used to approximate deprivation for each patient. Multiple imputations by a chained equation were performed to consider the influence of missing data on the results.ResultsTwenty percent of the 6415 patients operated on had severe postoperative complications at 90 days. In the multivariate regression analysis, increasing age, male sex, American Society of Anesthesiologists score ≥3, conversion to laparotomy or upfront open approach, surgical procedures, and perioperative transfusion were independent risk factors for severe postoperative complications. After adjusting for age, sex, body mass index, American Society of Anesthesiologists score, emergent setting, blood transfusion, indications for surgery, surgical approach, and procedures, the probability of severe postoperative complications increased with socioeconomic deprivation (P=0.026) by day 90.ConclusionsThis study highlights the potential influence of socioeconomic deprivation on the surgical outcomes of SD. Socioeconomic deprivation should be considered as a risk factor for severe postoperative complications during the preoperative assessment of the patient's medical conditions.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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