Place-based heterogeneity in lung transplant recipient outcomes.
Scientific Registry for Transplant Recipients (SRTR)
clinical research/practice
epidemiology
health services and outcomes research
lung (allograft) function/dysfunction
lung transplantation/pulmonology
registry/registry analysis
risk assessment/risk stratification
social sciences
Journal
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
ISSN: 1600-6143
Titre abrégé: Am J Transplant
Pays: United States
ID NLM: 100968638
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
revised:
14
07
2022
received:
17
02
2022
accepted:
11
08
2022
pubmed:
14
8
2022
medline:
6
12
2022
entrez:
13
8
2022
Statut:
ppublish
Résumé
Place is defined as a social or environmental area of residence with meaning to a patient. We hypothesize there is an association between place and the clinical outcomes of lung transplant recipients in the United States. In a retrospective cohort study of transplants between January 1, 2010, and December 31, 2019, in the Scientific Registry of Transplant Recipients, multivariable Cox regression models were used to test the association between place (through social and environmental factors) with readmission, lung rejection, and survival. Among 18,465 recipients, only 20% resided in the same county as the transplant center. Recipients from the most socially vulnerable counties when compared to the least vulnerable were more likely to have COPD as a native disease, Black or African American race, and travel long distances to reach a transplant center. Higher local life expectancy was associated with lower likelihood for readmission (odds ratio [OR] = 0.90, 95% confidence interval [CI]: 0.84, 0.98, p = .01). Higher social vulnerability was associated with a higher likelihood of lung rejection (OR = 1.37, [CI]: 1.07, 1.76, p = .01). There was no association of residence with posttransplant survival. Recipient place-based factors were associated with complications and processes of care after transplant and warrant further investigation.
Identifiants
pubmed: 35962587
doi: 10.1111/ajt.17170
pii: S1600-6135(23)00049-7
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
2981-2989Subventions
Organisme : NHLBI NIH HHS
ID : K23 HL138191
Pays : United States
Informations de copyright
© 2022 The American Society of Transplantation and the American Society of Transplant Surgeons.
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