Grinnan Dan, Kang Le, DeWilde Christine, Badesch David, Benza Raymond, Bull Todd, Chakinala Murali, DeMarco Teresa, Feldman Jeremy, Ford Hubert J, Klinger James, McConnell John, Rosenzweig Erika B, Sager Jeffrey, Shlobin Oksana, Zamanian Roham
Department of Medicine Virginia Commonwealth University Richmond Virginia USA.
Victoria Johnson Research Center Virginia Commonwealth University Richmond Virginia USA.
Pulm Circ. 2022 Jul 1;12(3):e12120. doi: 10.1002/pul2.12120. eCollection 2022 Jul.
Outcomes of patients with pulmonary arterial hypertension (PAH) may be associated with social determinants of health (SDOH) and other baseline patient characteristics. At present, there is no prognostic model to predict important patient outcomes in PAH based on SDOH. Utilizing information from the Pulmonary Hypertension Association Registry (PHAR), we derive a model (PHAR Evaluation or PHARE) to predict an important composite patient outcomes based on SDOH and other patient characteristics. Baseline data regarding SDOH from adult patients with PAH enrolled in the PHAR between 2015 and March 23, 2020, were included for analysis. We performed repeated measures logistic regression modeling with dichotomous outcome data (0 for no events, 1 for one or more events) to derive the PHARE. Here, 1275 consecutive adult patients enrolled in the PHAR from 47 participating centers were included. Variables included in our model are race, gender, ethnicity, household income, level of education, age, body mass index, drug use, alcohol use, marital status, and type of health insurance. Interaction effect between variables was analyzed and several interactions were also included in the PHARE. The PHARE shows a -statistic of 0.608 ( < 0.0001) with 95% confidence intervals (0.583, 0.632). Using SDOH and baseline characteristics from the PHAR, the PHARE correlates with our composite patient outcome. Further work evaluating the role of SDOH in prognostic modeling of PAH is indicated.
肺动脉高压（PAH）患者的预后可能与健康的社会决定因素（SDOH）及其他患者基线特征相关。目前，尚无基于SDOH预测PAH患者重要预后的模型。利用肺动脉高压协会注册中心（PHAR）的信息，我们建立了一个模型（PHAR评估或PHARE），以基于SDOH和其他患者特征预测重要的综合患者预后。纳入了2015年至2020年3月23日期间在PHAR登记的成年PAH患者的SDOH基线数据进行分析。我们对二分结局数据（无事件为0，一个或多个事件为1）进行重复测量逻辑回归建模以得出PHARE。此处纳入了来自47个参与中心的1275例连续成年PHAR登记患者。我们模型中的变量包括种族、性别、族裔、家庭收入、教育程度、年龄、体重指数、药物使用、酒精使用、婚姻状况和医疗保险类型。分析了变量之间的交互作用，PHARE中也纳入了几种交互作用。PHARE的卡方统计量为0.608（P<0.0001），95%置信区间为（0.583，0.632）。利用PHAR的SDOH和基线特征，PHARE与我们的综合患者预后相关。表明需要进一步开展评估SDOH在PAH预后建模中作用的工作。
