Supplemental Digital Content 8: Risk-Adjusted Rates of Outcomes for Emergency General Surgical Procedures by Subtheme Socioeconomic Vulnerability Quintiles
Socioeconomic vulnerability quintile Risk-adjusted rate*
(95% CI), % Odds ratio
(95% CI) p
Value Mortality, 30-d
Lowest socioeconomic vulnerability† 8.18 (8.07–8.29) Reference - Below average socioeconomic
vulnerability‡ 8.30 (8.19–8.41) 1.02 (1.02–1.03) <0.001
Average socioeconomic vulnerability§ 8.29 (8.18–8.40) 1.02 (1.02–1.03) <0.001 Above average socioeconomic
vulnerability‖ 8.42 (8.31–8.53) 1.05 (1.04–1.05) <0.001
Highest socioeconomic vulnerability¶ 8.61 (8.50–8.72) 1.06 (1.06–1.07) <0.001 Any complication
Lowest socioeconomic vulnerability 34.03 (33.82–34.24) Reference - Below average socioeconomic
vulnerability 35.11 (34.90–35.31) 1.06 (1.06–1.06) <0.001
Average socioeconomic vulnerability 35.49 (35.28–35.69) 1.08 (1.08–1.08) <0.001 Above average socioeconomic
vulnerability 36.25 (36.04–36.45) 1.13 (1.12–1.13) <0.001
Highest socioeconomic vulnerability 37.46 (37.24–37.67) 1.20 (1.20–1.21) <0.001 Serious complication
Lowest socioeconomic vulnerability 18.33 (18.13–18.52) Reference - Below average socioeconomic
vulnerability 18.99 (18.79–19.19) 1.05 (1.05–1.05) <0.001
Average socioeconomic vulnerability 19.27 (19.07–19.46) 1.07 (1.06–1.07) <0.001 Above average socioeconomic
vulnerability 19.88 (19.68–20.08) 1.11 (1.11–1.12) <0.001
Highest socioeconomic vulnerability 20.92 (20.71–21.13) 1.20 (1.19–1.20) <0.001 Reoperation
Lowest socioeconomic vulnerability 11.93 (11.80–12.06) Reference - Below average socioeconomic
vulnerability 12.10 (11.97–12.23) 1.01 (1.01–1.01) <0.001
Average socioeconomic vulnerability 12.17 (12.04–12.29) 1.01 (1.01–1.02) <0.001 Above average socioeconomic
vulnerability 12.24 (12.11–12.37) 1.02 (1.01–1.02) <0.001
Highest socioeconomic vulnerability 12.56 (12.43–12.69) 1.04 (1.03–1.04) <0.001 Readmission
Lowest socioeconomic vulnerability 15.04 (14.91–15.18) Reference - Below average socioeconomic
vulnerability 15.38 (15.24–15.51) 1.03 (1.03–1.03) <0.001
Average socioeconomic vulnerability 15.54 (15.41–15.67) 1.04 (1.04–1.04) <0.001 Above average socioeconomic
vulnerability 15.78 (15.65–15.91) 1.06 (1.06–1.06) <0.001
Highest socioeconomic vulnerability 16.15 (16.01–16.29) 1.09 (1.08–1.09) <0.001 Data Sources: Medicare Claims, 2014-2018; Social Vulnerability Index, 2018
Emergency general surgical procedures include appendectomy, cholecystectomy, colectomy, and ventral hernia repair
Socioeconomic status is 1 of the 4 Social Vulnerability subthemes and based on income, poverty, employment, and education.
*Model was adjusted for age, sex, year of procedure, patient to nurse ratio, hospital teaching status and Elixhauser comorbidities.
†Lowest census-tract socioeconomic vulnerability is defined as the lowest quintile by Social Vulnerability Index with subtheme score of 0 to 0.2.
‡Below average census-tract socioeconomic vulnerability is defined as the quintile by Social Vulnerability Index with subtheme score of 0.21-0.40.
§Average census-tract socioeconomic vulnerability is defined as the quintile by Social Vulnerability Index with subtheme score of 0.41-0.60.
‖Above average census-tract socioeconomic vulnerability is defined as the quintile by Social Vulnerability Index with subtheme score of 0.61 to 0.80.
¶ Highest census-tract socioeconomic vulnerability is defined as the highest quintile by Social Vulnerability Index with subtheme score of 0.81 to 1.
