{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:57:18Z","timestamp":1777564638446,"version":"3.51.4"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,12,3]],"date-time":"2024-12-03T00:00:00Z","timestamp":1733184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surgical resection for pancreas ductal adenocarcinoma (PDAC) remains the mainstay of treatment. Regardless of enhanced survival rates, disparities in patient outcomes and experiences driven by the social determinants of health (SDH) persist. The area deprivation index (ADI) comprises 17 indicators related to education, employment, housing\u2010quality, and poverty. We sought to examine the impact of ADI on surgical outcomes of PDAC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent pancreatoduodenectomy or distal pancreatectomy for PDAC between January 2011 and December 2022 were identified. ADI was calculated using patient zip codes and categorized into quartiles, with the highest indicating the most marginalized. The primary outcome was loss to follow\u2010up after surgical resection. To account for confounders, a competing risk multivariable regression analysis was used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1001 patients had a mean age of 66.6 (\u00b19.64), with 46.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009463) of patients being female. A majority, 94.6% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009947), identified as white, and 64.1% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009641) had at least a college degree. The median length of follow\u2010up after surgery was 1.8 years (interquartile range: 0.9\u20133.5). Multivariable analysis adjusting for competing risk of death, showed that patients who are least marginalized are 1.57 times more likely to have their follow\u2010up than those most marginalized (hazard ratio: 1.57, 95% confidence interval: 1.08\u20132.29,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SDH impact many aspects of patient's care including a higher risk of loss to follow\u2010up for marginalized patients after surgery for PDAC. Future efforts should seek to identify and lower barriers faced by marginalized patients with system\u2010level changes to ensure equitable access.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.28002","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T01:45:08Z","timestamp":1733276708000},"page":"827-833","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Influence of Area Deprivation Index on Surgical Outcomes in Pancreas Cancer"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9721-2808","authenticated-orcid":false,"given":"Hala","family":"Muaddi","sequence":"first","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Glasgow","sequence":"additional","affiliation":[{"name":"Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad K.","family":"Abou Chaar","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1140-003X","authenticated-orcid":false,"given":"Elizabeth","family":"Habermann","sequence":"additional","affiliation":[{"name":"Kern Center for the Science of Health Care Delivery Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Starlinger","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanne","family":"Warner","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rory","family":"Smoot","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Kendrick","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Truty","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cornelius A.","family":"Thiels","sequence":"additional","affiliation":[{"name":"Department of Surgery Mayo Clinic Rochester Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,3]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21626"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21551"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.25036"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1091-255X(00)80105-5"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200112000-00007"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003706"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/2819372"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13-2946"},{"issue":"3","key":"e_1_2_8_10_1","first-page":"1238","article-title":"Introduction of an Area Deprivation Index Measuring Patient Socioeconomic Status in an Integrated Health System: Implications for Population Health","volume":"4","author":"Knighton A. 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