肝移植结果的差异:种族/族裔以及个人和邻里层面的社会经济状况。

IF 1.7 4区 医学 Q2 NURSING
Clinical Nursing Research Pub Date : 2024-09-01 Epub Date: 2024-08-27 DOI:10.1177/10547738241273128
Niharika Gummaraj Srinivas, Ye Chen, Angie Mae Rodday, Dami Ko
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引用次数: 0

摘要

种族/民族和个人层面的社会经济地位(SES)可能会导致肝移植(LT)结果的健康差异。社区的社会经济条件可能会减轻或加剧这些健康差异。这项回顾性研究调查了种族/民族、个人和邻里社会经济地位与肝移植结果之间的关系,以及邻里社会经济地位是否改变了个人因素与肝移植结果之间的关系。研究人员从器官共享联合网络数据库中找到了在2010年至2019年间接受LT手术的成年人(n = 55,688)。主要暴露因素包括种族/民族、教育程度、主要保险类型和社会贫困指数(SDI)得分。教育程度和主要保险类型代表个人层面的社会经济地位,而 SDI 分数则代表邻里层面的社会经济地位。主要结果是发生移植失败或死亡的时间。我们使用 Cox 比例危险模型来检验暴露与结果之间的关联。黑人(危险比 [HR]:1.27,p p = .002)和有公共保险(HR:1.14,p p = .45)的LT受者并没有改变个人因素与LT结果之间的关联。本研究的结果表明,基于个体因素的差异并不会因邻里层面的社会经济条件而改变。需要针对与种族/民族和个人水平 SES 相关的独特需求采取有针对性的干预措施,以优化 LT 结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Disparities in Liver Transplant Outcomes: Race/Ethnicity and Individual- and Neighborhood-Level Socioeconomic Status.

Race/ethnicity and individual-level socioeconomic status (SES) may contribute to health disparities in liver transplant (LT) outcomes. The socioeconomic conditions of a neighborhood may either mitigate or exacerbate these health disparities. This retrospective study investigated the relationship between race/ethnicity, individual- and neighborhood-level SES, and LT outcomes, and whether neighborhood-level SES modified the relationship between individual factors and LT outcomes. Adult individuals who underwent LT between 2010 and 2019 (n = 55,688) were identified from the United Network for Organ Sharing database. Primary exposures were race/ethnicity, education, primary insurance type, and the Social Deprivation Index (SDI) scores. Education and primary insurance type were used as proxies for individual-level SES, while SDI scores were used as a proxy for neighborhood-level SES. The primary outcome was time to occurrence of graft failure or mortality. Cox proportional hazard models were used to examine the associations between the exposures and outcomes. LT recipients who were Black (hazard ratio [HR]: 1.27, p < .0001), completed high school or less (HR: 1.06, p = .002), and had public insurance (HR: 1.14, p < .0001) had a higher rate of graft failure or mortality than those who were White, completed more than high school, and had private insurance, respectively. The SDI scores were not significantly associated with LT outcomes when adjusting for individual factors (HR: 1.02, p = .45) and did not modify the associations between individual factors and LT outcomes. Findings of this study suggest that disparities based on individual factors were not modified by neighborhood-level SES. Tailored interventions targeting the unique needs associated with race/ethnicity and individual-level SES are needed to optimize LT outcomes.

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来源期刊
CiteScore
3.40
自引率
5.90%
发文量
107
审稿时长
>12 weeks
期刊介绍: Clinical Nursing Research (CNR) is a peer-reviewed quarterly journal that addresses issues of clinical research that are meaningful to practicing nurses, providing an international forum to encourage discussion among clinical practitioners, enhance clinical practice by pinpointing potential clinical applications of the latest scholarly research, and disseminate research findings of particular interest to practicing nurses. This journal is a member of the Committee on Publication Ethics (COPE).
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