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An Examination of How Social Determinants of Health Impact Sarcoma Reconstruction Outcomes
Patrick Kennedy BS, Shayoni Nag DO, Emily Rice MCR, CCRP RD; Julie West PA-C; Jason Souza MD; Amy M. Moore MD
The Ohio State University College of Medicine
2024-12-18
Presenter: Patrick Kennedy
Affidavit:
Amy M. Moore
Director Name: Amy M. Moore
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: General Reconstruction
Background: Sarcomas are a rare tumor of the soft tissue and bone that can be treated with limb salvage surgery or amputation after resection. Studies have shown that Social Determinants of Health (SDH) impact post-operative complications and outcomes, but there is no research on their impact on outcomes of reconstructive surgery. The study aimed to determine the impact of SDH on surgical outcomes of sarcoma patients who have undergone primary resection and reconstruction with limb salvage or amputation.
Methods: A retrospective review study included 152 patients from 2013-2023, representing 21 types of sarcomas, and 5 types of reconstructive surgeries. Geographic Identifiers (GEOIDs) were collected and identified community SDH of these patients. The number of and reason for ED visits, follow-up surgeries, and readmissions were also collected
Results: Patients from communities with lower income to poverty ratios are strongly associated with increased ED visit rates (p=0.012*), patients under 65 years old with public insurance have significantly more ED visits as compared to those with private insurance (p=0.0004**), and patients from communities with populations <0.5x under the poverty-threshold have significantly higher readmission rates than those who are 1x under the poverty-threshold and >2x above the poverty-threshold (both p=0.032*).
Conclusion This statistically significant study is the first to identify the critical gap in understanding how social determinants of health impact sarcoma reconstruction outcomes through identification of disparities in outcomes. Future studies with larger sample sizes will guide surgeons on how to create more equitable healthcare practices and interventions for sarcoma patient populations.
