by McHenry, Ryan
D.; Moultrie, Christopher E. J.; Quasim, Tara; Mackay, Daniel F.; Pell, Jill P.
Critical Care Medicine, December 26, 2022.
Objectives:
Socioeconomic status is well established as a key
determinant of inequalities in health outcomes. Existing literature examining
the impact of socioeconomic status on outcomes in critical care has produced
inconsistent findings. Our objective was to synthesize the available evidence
on the association between socioeconomic status and outcomes in critical care.
Data Sources:
A systematic search of CINAHL, Ovid MEDLINE, and EMBASE was
undertaken on September 13, 2022.
Study Selection:
Observational cohort studies of adults assessing the
association between socioeconomic status and critical care outcomes including
mortality, length of stay, and functional outcomes were included. Two
independent reviewers assessed titles, abstracts, and full texts against eligibility
and quality criteria.
Data Extraction:
Details of study methodology, population, exposure measures,
and outcomes were extracted.
Data Synthesis:
Thirty-eight studies met eligibility criteria for systematic
review. Twenty-three studies reporting mortality to less than or equal to 30
days following critical care admission, and eight reporting length of stay,
were included in meta-analysis. Random-effects pooled analysis showed that
lower socioeconomic status was associated with higher mortality at less than or
equal to 30 days following critical care admission, with pooled odds ratio of
1.13 (95% CIs, 1.05–1.22). Meta-analysis of ICU length of stay demonstrated no
significant difference between socioeconomic groups. Socioeconomic status may
also be associated with functional status and discharge destination following
ICU admission.
Conclusions:
Lower socioeconomic status was associated with higher
mortality following admission to critical care.
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