The impact of socioeconomic status on outcomes of peripheral arterial disease in North-East Ireland.

BACKGROUND

Socioeconomic status (SES) has a measurable and significant effect on cardiovascular morbidity and mortality.

AIM: The objective of this study was to assess the relationship between SES and peripheral arterial disease (PAD).

METHODS

This is a retrospective, observational cohort study of all adult patients that were admitted with PAD between 2014 and 2020. Patients with a valid Irish postal address were assigned a SES score and quartile based on the Pobal Hasse-Pratschke (HP) deprivation index. Cox proportional hazards models and Kaplan-Meier survival analysis were used to determine the relationship between SES and primary outcome measures including revascularisation, amputation and overall survival.

RESULTS

A total of 800 patients were included. SES scores demonstrated a significant left shift when compared to the general population, indicating lower SES in the PAD cohort (combined Kolmogorov-Smirnov test p < 0.0001). SES score was not associated with repeat revascularisation (HR 1.00, 95% CI 0.99-1.02, p = 0.579). Lower SES score was associated with an increased risk of repeat amputation (HR 0.97, 95% CI 0.942-0.996, p = 0.027). Patient survival was not associated with SES status (HR 1.00, 95% CI 0.99-1.01, p = 0.688). A log-rank test showed no significant difference in overall survival by SES quartile (χ²(3) = 1.45, p = 0.693).

CONCLUSION

In the North-East of Ireland, patients with PAD exhibited a higher incidence of socioeconomic deprivation compared to the general population. Lower socioeconomic status conferred a small increased risk of repeat amputation. However, there was no demonstratable difference in repeat revascularisation and overall survival rates across the social gradient.