SP6.3 Prognostic significance of Socio-Economic Deprivation on OGD outcome
Catherine Eley, Neil Hawkes, Emma Barlow, Geraint Herbert, Richard Egan, Wyn Lewis- Surgery
Abstract
Introduction
Socio-Economic Deprivation has long been associated with many gastrointestinal diseases yet its influence on OesophagoGastroDuodenoscopy (OGD) findings has not been evaluated. The aim of this study was to investigate the influence of deprivation on outcomes of OGD irrespective of referral reason.
Method
Two-thousand consecutive patients presenting to four Health Boards in Wales (June 2019-) were studied retrospectively with deprivation scores calculated using the Wales Indices of Multiple Deprivation (WIMD). Patients were subclassified into Quintiles for analysis (Q1 most, Q5 least Deprived).
Results
Inhabitants of the most deprived areas were more likely to be diagnosed with Peptic Ulcer (Q1 7.9%, Q5 4.7%; OR 0.498, p=0.018), Severe Oesophagitis (LA4, Q1 2.7% v Q5 0%, OR 0.089, p=0.002), Helicobacter Pylori infection (Q1 5.4%, Q5 1.7%; OR 0.284, p=0.002), but less likely to be diagnosed with Barrett’s Oesophagus (Q1 6.3% v Q5 12.3%, OR 2.146, p=0.004) than those from least deprived areas. New cancer diagnoses numbered 53 and were proportionately higher after Urgent Suspected Cancer (USC) referral (n=35, 4.6%) with three diagnosed after routine OGD (0.6%, p<0.001). Deprivation was associated more advanced radiological perceived Stage III Cancer (Q1 16.1% v Q2 55.6% v Q5 5.6%, OR 0.007, p=0.005).
Conclusion
Deprivation was associated with two-fold more peptic ulcer disease, three-fold more Helicobacter Pylori infection, and 12-fold more severe oesophagitis, which correlated with up to 10-fold more advanced cancer stage at diagnosis.