Associations Between Social Determinants of Health and Cardiovascular Complications After Hand Surgery: Examining the Role of Income, Unemployment, Insurance, and Education

This study examines the impact of social determinants of health (SDoH) on cardiovascular complications after hand surgery, focusing on income, unemployment, insurance, and education. Using PearlDiver data (2011 – 2022), adult patients with Medicare Advantage, Medicaid, or private insurance were analyzed. Cardiovascular complications (e.g., cardiac arrest, deep vein thrombosis, arrhythmia, pulmonary embolism, myocardial infarction) within 90 and 365 days post-surgery were assessed via logistic regression adjusted for demographics and SDoH. Among 1,693,829 patients (mean age 66.3, 64% female), 0.9% had complications at 90 days, 2.3% at 365 days. Higher income and insurance rates reduced risk, while unemployment increased it. Education showed no significant effect. Lower income, higher unemployment, and reduced insurance coverage predict cardiovascular risks after hand surgery, highlighting the need for addressing socioeconomic disparities to improve outcomes. (Journal of Surgical Orthopaedic Advances 35(2):081–085, 2026)

Key words: complications, cardiovascular, hand surgery, socioeconomics, demographics