Title : ICD-10 Z Codes and social determinants of health in emergency department encounters for salpingitis and oophoritis
Abstract:
Objective: This study characterized the demographic and clinical profile of patients with documented social determinants of health (SDOH) ICD-10 Z codes (Z55–Z65) who presented to the emergency department (ED) with salpingitis and oophoritis, and explores patterns of healthcare utilization and management.
Methods: This retrospective cohort study used TriNetX Research Network data to compare adult females (ages 18-49) presenting to the ED with diagnosed salpingitis and oophoritis between 01/01/2000 - 01/01/2024, by presence or absence of SDOH Z codes. Propensity score matching balanced baseline demographics and comorbidities. Outcomes were assessed one year from ED presentation and included surgical intervention, hospital admission, ED revisits, utilization of critical care service, analgesic use, and new mental health diagnoses such as anxiety, post-traumatic stress disorder, and depression. Risk analyses compared outcome proportions between cohorts, reported as risk ratios (RR) with 95% confidence intervals.
Results: 5,570 matched patients were analyzed. Patients with documented SDOH Z codes were less likely to receive surgery (RR: 0.679, p<0.001), but more likely to be hospitalized (RR: 1.333, p<0.001), revisit the ED (RR:1.287, p<0.001), require critical care services (RR: 1.757, p<0.001), and experience new mental health diagnoses including depression (RR: 1.890, p<0.001), anxiety (RR: 1.565, p<0.001), and post-traumatic stress disorder (RR: 3.026, p<0.001) within 1 year of their original visit to the ED.
Conclusion: Documented SDOH Z codes were associated with increased risk of ED repeat visits, hospitalization, need for critical care, and mental health conditions. These findings highlight the clinical relevance of SDOH in influencing acute care utilization and patient outcomes, underscoring the importance of routine screening and documentation of SDOH in electronic health records. Addressing underlying social needs may be a key strategy in reducing healthcare burden and improving long-term outcomes for vulnerable populations.
