Impact of Socioeconomic Deprivation on Early and Long-Term Outcomes After Major Aortic Surgery: Insights From a 20-Year Single-Centre Cohort

This 20-year single-center study examined the impact of socioeconomic deprivation on outcomes after major aortic surgery in 2,010 patients within the UK’s publicly funded healthcare system. Among those undergoing emergency repair for acute type A aortic dissection, patients from the most deprived communities had significantly higher in-hospital mortality (20.0 percent vs 11.6 percent) and lower 10-year survival (56.0 percent vs 69.4 percent) than their least deprived counterparts. Socioeconomic deprivation remained independently associated with both early mortality (OR 2.44, 95 percent CI 1.20–4.96) and long-term mortality (HR 1.67, 95 percent CI 1.22–2.28). In contrast, no association was observed between deprivation and postoperative or long-term outcomes following elective or urgent major aortic surgery. These findings suggest that social deprivation has its greatest impact in acute aortic emergencies, where delayed presentation and challenges with long-term surveillance may contribute to worse outcomes despite treatment within a universal healthcare system.