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Poster Display - 73
Correlation between Social Determinants of Health and Outcomes in Congenital Paediatric Surgery
Esther Harlow Boardman, Juhi Agarwal, Farah Elmi, Ayesha Rahman
King's College, London, UK
Background
Congenital gastrointestinal anomalies, including Congenital Diaphragmatic Hernia (CDH),
Oesophageal Atresia (OA), Hirschsprung's Disease (HD), and Anorectal Malformations
(ARMs), result in complex, long-term challenges. While anatomical factors are
well-understood, the impact of social determinants of health (SDoH) remains underexplored.
Aim(s)/Objectives
This study investigates the relationship between SDoH and long-term clinical outcomes in
paediatric patients with CDH, OA, HD, and ARMs, focusing on post-surgical challenges.
Methods
A retrospective cohort study at Evelina London Children’s Hospital analysed data from
twenty-four patients diagnosed with CDH, OA, HD, and ARMs. SDoH risk factors were
assessed using the EPIC Hyperspace database and the Index of Multiple Deprivation (IMD), correlated with clinical outcomes, including bowel function scores (BFS), hospital
admissions, recurrence, and condition-specific complications.
Results
50% of CDH patients experienced unplanned readmissions, and 83% experienced respiratory symptoms, independent of SDoH risk. All OA patients had unplanned readmissions; 100% medium-risk OA patients required dilatations, compared to 50% of low-risk patients. BFS were assessed in patients over two years with HD and ARMs. No clear correlation with SDoH emerged, though poor BFS were more common in high-risk patients. Financial strain was the most prevalent SDoH.
Discussion/Conclusion
Although no definitive correlations were established, data indicated that financial strain, education and healthcare accessibility affected post-surgical recovery. Trends suggested associations between lower SDoH and unplanned readmissions in CDH, increased dilatation requirements in OA, and bowel function impact in HD and ARMs. These findings underscore the multifactorial nature of congenital conditions and call for larger studies to refine SDoH assessments for equitable care.