EP424 - Assessing the Impact of Census Block-Level Socioeconomic Disadvantage on Colorectal Surgery Outcomes Using the Area Deprivation Index

Sunday, May 11, 2025

12:35 PM – 12:40 PM PT

Location: Monitor 4, Sails Pavilion, Upper Level

ePoster Presenter(s)

Daniel A. Metzger, MD

Resident
Weill Cornell Medicine
New York Presbyterian/Weill Cornell
New York, NY, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Author(s)

HH

Haley Harris, n/a

Research Assistant
Weill Cornell Medicine
New York, New York, United States

Disclosure information not submitted.
Julie Hong, MD

Resident
NewYork Presbyterian - Queens
Flushing, NY, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
SK

Shahenda Khedr, BA

Research
New York Presbytarian Queens
New York, New York, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
HW

Hanna Weitzman-Flanigan, MSN, NP-C, CNOR

NSQIP Manager, Lead Surgical Outcomes Coordinator
NY Presbyterian Queens
Queens, New York, United States

Disclosure information not submitted.
YL

Ying Li, n/a

Research Biostatistician I
Weill Cornell Medicine
UNION CITY, New Jersey, United States

Disclosure information not submitted.
JB

Julianna Brouwer, MPH

Research Administrator
Weill Cornell Medicine
New York, New York, United States

Disclosure information not submitted.
JM

Jialin Mao, MD, PhD

Assistant Professor
Weill Cornell Medicine
New York, New York, United States

Disclosure information not submitted.
Heather Yeo, MD, MBA, MS (she/her/hers)

Associate professor of Surgery
Weill Cornell medicine
Weill Cornell Medicine
New York, New York, United States

Disclosure information not submitted.
CF

Christopher Foglia, MD

Assistant Professor
Weill Cornell School of Medicine
New York, New York, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
RP

Roger Patron-Lozano, MD

Assistant Professor
Weill Cornell Medicine
Flushing, New York, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

SC

Steven Y. Chao, MD FACS

Assistant Professor of Clinical Surgery
Weill Cornell Medicine
Flushing, New York, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Daniel A. Metzger, MD: This individual has no financial relationships with ineligible companies.

Julie Hong, MD: This individual has no financial relationships with ineligible companies.

Shahenda Khedr, BA: This individual has no financial relationships with ineligible companies.

Christopher Foglia, MD: This individual has no financial relationships with ineligible companies.

Roger Patron-Lozano, MD: This individual has no financial relationships with ineligible companies.

Steven Y. Chao, MD FACS: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: The impact of socioeconomic factors on patient outcomes can be difficult to study in densely populated, urban environments as socioeconomic status varies widely within small geographic areas. The area deprivation index (ADI) provides a measure of socioeconomic disadvantage at the census block group level, allowing for greater granularity than other census-based measures. We aimed to examine the association between ADI and postoperative outcomes after colorectal surgery.

Methods/Interventions: Data was obtained from the National Surgical Quality Improvement Program at New York-Presbyterian/Queens and augmented with additional data from chart review. We included patients who underwent surgery for colorectal surgery from 2017-2021, excluding emergent cases and cases not performed by a colorectal surgeon. Demographic and clinicopathologic variables, ADI, and postoperative outcomes were analyzed. Patients with an ADI ≥7 were categorized as high deprivation. Factors associated with prolonged hospital stay (> 6 days) and 30-day postoperative complications were identified using multivariate logistic regression adjusting for age, body mass index, diabetes, and tumor site.

Results/Outcomes: Overall, our cohort included 233 patients with a median age of 68 years (IQR 57-76) and an even gender distribution. Eleven percent of patients classified as high deprivation by ADI. On multivariate analysis, high ADI was associated with increased risk of 30-day postoperative complication (OR 1.57, 95% CI 0.50-4.44; p-0.4) and significantly increased risk of prolonged hospital stay (OR 3.05, 95% CI 0.96-8.82; p-0.045). Tumor site, BMI, and presence of diabetes did not appear to significantly impact risk of prolonged hospital stay or 30-day postoperative complications in our cohort. However, age was significantly associated with risk of 30-day postoperative complications (OR 1.03, 95% CI 1.00-1.07; p-0.030).

Conclusion/Discussion: High area deprivation, as measured by the Area Deprivation Index (ADI), is associated with significantly increased odds of prolonged hospital stay after elective surgery for colorectal cancer. While there was a trend toward higher rates of postoperative complications in patients with high ADI, this was not statistically significant. Overall, these results highlight the need for targeted interventions to improve postoperative outcomes in disadvantaged populations.