Social Deprivation and Postoperative Mortality

NCT07621211 | Not Yet Recruiting

• 1 other identifier: 2025-0217
• Study Type: observational
• Target: 45,000
• Locations: 1 country
• Sites: 7

Brief Summary

Socioeconomic factors are associated with differences in health outcomes, but their impact on surgical patients is still not well understood, especially in low- and middle-income countries. Social deprivation may affect perioperative outcomes through differences in access to healthcare, burden of comorbidities, timing of care, and hospital resources. However, few studies have evaluated this association in large and diverse surgical populations, and data from Brazil are limited. This retrospective multicenter cohort study will evaluate the association between socioeconomic deprivation and perioperative outcomes among patients undergoing surgery in Brazil. The study will include patients aged 16 years or older who underwent elective or urgent surgical procedures in participating public and private hospitals between January 1 and December 31, 2024. Patients undergoing ophthalmologic procedures, diagnostic procedures, procedures performed under local anesthesia only, selected transplant procedures, and organ donors after brain death will be excluded. Socioeconomic deprivation will be assessed using georeferenced area-level indices derived from each patient's residential address, including the Brazilian Deprivation Index, the Social Vulnerability Index, and the Municipal Human Development Index. The researchers will grou patients according to deprivation levels, and analyze the association between deprivation and postoperative outcomes. The primary outcome will be 30-day in-hospital postoperative mortality. The study will also evaluate demographic, clinical, surgical, and hospital-level factors associated with mortality, including age, sex, ethnicity, American Society of Anesthesiologists physical status classification, surgical urgency, surgical magnitude, surgical specialty, and type of healthcare system. Multivariable logistic regression models will be used to assess whether socioeconomic deprivation is independently associated with postoperative mortality after adjustment for relevant clinical and surgical factors. The results of this study may improve the understanding of how socioeconomic deprivation influences perioperative risk in Brazil. The findings may help identify vulnerable surgical patients, support risk prediction models that include social determinants of health, and inform strategies to reduce inequities in perioperative care.

Conditions

Social Deprivation

Keywords

surgical procedures; social deprivation; risk factors

Outcome Measures

Primary Outcomes (1)

• 30-day in-hospital postoperative mortality

  Number of participants who died during the hospital stay within 30 days after the index surgical procedure. Mortality will be assessed using routinely collected hospital electronic records, including the date of surgery, date of hospital discharge, and date of in-hospital death when applicable. Participants discharged alive before 30 days will be considered alive for this outcome. Participants who remain hospitalized beyond 30 days will be assessed up to postoperative day 30 only. This is a binary outcome, reported as death or no death within 30 days after surgery.

  30 days

Secondary Outcomes (1)

• Admission to intensive care unit or regular ward after surgery

  Immediate postoperative destination

Study Arms (1)

2024 Surgical Patients

Patients aged 16 years or older who underwent elective or urgent surgical procedures in participating Brazilian hospitals between January 1 and December 31, 2024. Participating centers will include public and private hospitals. The cohort will be identified retrospectively from routinely collected hospital electronic records. There will be no study intervention and no change in patient care. The exposure of interest is socioeconomic deprivation, assessed using georeferenced area-level indices derived from each patient's residential address. Patients will be categorized according to levels of socioeconomic deprivation, and perioperative outcomes will be compared across these groups.

Eligibility Criteria

• Age: 16 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Study participants will be selected from surgical patients treated at participating public and private hospitals in Brazil. The participating centers are Hospital São José in Criciúma, Santa Catarina; Hospital de Clínicas de Porto Alegre and Hospital Nossa Senhora da Conceição in Porto Alegre, Rio Grande do Sul; Hospital São Domingos in São Luís, Maranhão; Hospital Marcelino Champagnat in Curitiba, Paraná; Hospital São Paulo in São Paulo, São Paulo; and Hospital da Universidade Federal da Bahia in Salvador, Bahia. These hospitals represent different geographic regions of Brazil and include both public and private healthcare settings.

You may qualify if:

• Patients aged 16 years or older.
• Patients who underwent an elective or urgent surgical procedure in an operating room at a participating hospital.
• Surgical procedure performed between January 1, 2024, and December 31, 2024.

You may not qualify if:

• Patients who underwent ophthalmologic surgery, diagnostic procedures only and procedures performed under local anesthesia only.
• Patients who underwent liver, lung or heart transplantation.
• Patients diagnosed with brain death who were organ donor candidates.

Sponsors & Collaborators

• Federal University of Rio Grande do Sul: collaborator
• Hospital de Clinicas de Porto Alegre: lead

Study Sites (7)

Hospital das Clínicas da Universidade Federal da Bahia

Salvador, Estado de Bahia, 40110-060, Brazil

Location

Hospital São Domingos

São Luís, Maranhão, 65060-645, Brazil

Location

Hospital São Marcelino Champagnat

Curitiba, Paraná, 80050-370, Brazil

Location

Hospital São José

Criciuma, Rio Grande do Sul, 88.811-500, Brazil

Location

Hospital de Clínicas de Porto Alegre

Porto Alegre, Rio Grande do Sul, 90410-000, Brazil

Location

Hospital Nossa Senhora da Conceição

Porto Alegre, Rio Grande do Sul, 91350-200, Brazil

Location

Hospital São Paulo

São Paulo, São Paulo, 04038-032, Brazil

Location

Study Officials

• Luciana PC Stefani, Md, PhD

  Hospital de Clínicas de Porto Alegre

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Alexandre Weber, Md

CONTACT

5554991902752; aleweber@hcpa.edu.br

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 27, 2026
• First Posted: June 2, 2026
• Study Start: May 15, 2026
• Primary Completion (Estimated): May 1, 2027
• Study Completion (Estimated): December 1, 2028
• Last Updated: June 2, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

BR (7)