Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 756 - файл

Low socioeconomic status, independent of race, is strongly associated with increased postoperative mortality and readmission following high-risk surgeries such as AAA repair, CABG and CEA [11– 15]. Impoverished patients are signicantly more likely to present with ruptured AAA or symptomatic disease at initial carotid revascularizations, as well as more likely to undergo emergency rather than elective repair compared to patients of higher income class [11, 13]. Such differences in low­income populations may be attributed to decreased compliance with health screening, decreased access to primary care coverage, and increased use of low-volume surgeons [13]. It is logical to assume that the racial disparity is rooted in lower SES, as many of the same contributing SDOH are often cited when studying race and economic status, however SES does not fully explain outcome disparities as Black patients have worse outcomes following cardiac procedures than White patients of similar SES [15]. This suggests racism plays a fundamental role in disease or access to care and these health­care disparities cannot be solely attributed to economic status. It is clear that while prior disease state affects surgical outcomes, there is no one sole contributor to risk. Rather, outcomes are affected by the complex interplay between socioeconomic sta­tus, access to health care, and the adverse effects (both generational and current) of stress and racism on overall health and wellbeing.