Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Socioeconomic Position and Health Outcomes Following Critical Illness: A Systematic Review

Jones, Jennifer R. A. DPT1,2; Berney, Sue PhD1,2; Connolly, Bronwen PhD1,3,4,5; Waterland, Jamie L. BPT(Hons)1; Denehy, Linda PhD6,7; Griffith, David M. MD8; Puthucheary, Zudin A. PhD9,10

doi: 10.1097/CCM.0000000000003727
Online Review Articles
Buy
SDC

Objectives: Systematically review evidence examining association between preadmission socioeconomic position and physical function, health-related quality of life and survival following critical illness.

Data Sources: Four electronic databases (MEDLINE, Embase, CINAHL, CENTRAL) and personal libraries were searched. Reference lists of eligible articles were cross-checked.

Study Selection: Primary quantitative studies reporting association between socioeconomic position and physical function, health-related quality of life, or survival of adults admitted to the ICU were included.

Data Extraction: Performed by two reviewers independently in duplicate using a prepiloted data extraction form. Quality appraisal was completed by two reviewers independently in duplicate using standardized algorithms and checklists. The Preferred Reporting Items for Systematic Reviews guidelines were followed.

Data Synthesis: From 1,799 records, 10 studies were included, one examining association of socioeconomic position with health-related quality of life and five with survival. Four studies accounted for socioeconomic position in survival analyses. Patients with lower socioeconomic position were found to have higher ICU, in-hospital, 30-day, and long-term mortality and lower 6-month Short Form-12 Mental Component Summary scores. No articles examined socioeconomic position and performance-based physical function. Notable variability in methods of socioeconomic position assessment was observed.

Conclusions: Lower socioeconomic position is associated with higher mortality and lower 6-month Short Form-12 Mental Component Summary scores following critical illness. Effect on performance-based physical function is unknown. We make recommendations for consistent socioeconomic position measurement in future ICU studies.

1Department of Physiotherapy, The University of Melbourne, Parkville, VIC, Australia.

2Department of Physiotherapy, Austin Health, Heidelberg, VIC, Australia.

3Lane Fox Clinical Respiratory Physiology Research Centre, Guy’s and St. Thomas’ NHS Foundation Trust, London, United Kingdom.

4NIHR Biomedical Research Centre at Guy’s and St. Thomas’ NHS Foundation and King’s College London, London, United Kingdom.

5Centre for Human and Applied Physiological Sciences, King’s College London, London, United Kingdom.

6Melbourne School of Health Sciences, The University of Melbourne, Parkville, VIC, Australia.

7Allied Health, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.

8Anaesthesia, Critical Care and Pain Medicine, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.

9William Harvey Research Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, United Kingdom.

10Adult Critical Care Unit, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom.

Drs. Griffith and Puthucheary are joint senior authors.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals.lww.com/ccmjournal).

Ms. Jones received funding from Australian Government Research Training Program Scholarship. Dr. Puthucheary received funding for consultancy from GlaxoSmithKline, Fresenius Kabi, and Lyric Pharmaceuticals and speaker fees from Orion. The remaining authors have disclosed that they do not have any potential conflicts of interest.

Prospective Register of Systematic Reviews identification number: CRD42017084114.

For information regarding this article, E-mail: jrjones@student.unimelb.edu.au

Copyright © 2019 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.