Social isolation in patients hospitalized for a surgery, does it matter?

Abstract

Background: Patients undergoing surgery often experience postoperative complications, sometimes leading to unplanned readmissions or prolonged hospital stay. Physical and mental factors have been identified as predictors for postoperative complications, however, the impact of social isolation during hospital admission on clinical outcomes after surgery has not yet been explored. Aim: To explore the relationship between inpatient social isolation and unplanned readmissions within 90 days after surgery. Secondary objectives were to evaluate relationships between social isolation and mortality, initial and total hospital length of stay (LOS), and related factors to social isolation. Methods: Patients undergoing vascular, gastro-intestinal, urological, trauma or orthopaedic surgery in a Dutch tertiary hospital were included in this cohort study. Social isolation was measured during hospitalization using the Friendship Scale (FS). Logistic and multivariable linear regression models, adjusted for confounders using propensity scores, were used to explore relationships. Results: In total, 118 patients were included. Almost half (48.3%) underwent (oncological) gastro-intestinal surgery. 29 patients (24.6%) were readmitted at least once and 3 patients (2.5%) died. Median FS score was 3 out of 21 (IQR = 1; 5). No significant relationships were observed between social isolation and unplanned readmission (p = .478), initial and total LOS (p = .657; p .601, respectively). Living with others, but without partner, and less quality-adjusted life years (QALYs) were significantly related to a higher degree of social isolation (p =.009, p = .002, respectively). Conclusion and implications of key findings: No relationships were found between inpatient social isolation and unplanned readmissions, initial or total LOS. Living with others, but without partner, and less QALYs were related to a higher sense of social isolation. Related to other studies, it remains important to focus in clinical practice on patients’ personal and social factors.