Department of Cardiology, Lucile Packard Children's Hospital at Stanford, Palo Alto, California, USA.
Quantitative Sciences Unit, Stanford University of Medicine, Palo Alto, California, USA.
Pediatr Transplant. 2024 Mar;28(2):e14695. doi: 10.1111/petr.14695.
Disparities in pediatric heart transplant outcomes based on socioeconomic status (SES) have been previously observed. However, there is a need to reevaluate these associations in contemporary settings with advancements in transplant therapies and increased awareness of health disparities. This retrospective study aims to investigate the relationship between SES and outcomes for pediatric heart transplant patients.
Data were collected through a chart review of 176 pediatric patients who underwent first orthotopic heart transplantation (OHT) at a single center from 2013 to 2021. The Area Deprivation Index (ADI), a composite score based on U.S. census data, was used to quantify SES. Cox proportional hazards models and generalized linear models were employed to analyze the association between SES and graft failure, rejection rates, and hospitalization rates.
The analysis revealed no statistically significant differences in graft failure rates, rejection rates, or hospitalization rates between low-SES and high-SES pediatric heart transplant patients for our single-center study.
There may be patient education, policies, and social resources that can help mitigate SES-based healthcare disparities. Additional multi-center research is needed to identify post-transplant care that promotes patient equity.
先前观察到,基于社会经济地位(SES)的儿科心脏移植结局存在差异。然而,随着移植治疗的进步和对健康差异认识的提高,需要在当代背景下重新评估这些关联。本回顾性研究旨在调查 SES 与儿科心脏移植患者结局之间的关系。
通过对 2013 年至 2021 年期间在单一中心接受首次原位心脏移植(OHT)的 176 名儿科患者的图表回顾收集数据。使用基于美国人口普查数据的综合得分——区域贫困指数(ADI)来量化 SES。采用 Cox 比例风险模型和广义线性模型分析 SES 与移植物衰竭、排斥率和住院率之间的关联。
对于我们的单中心研究,低 SES 和高 SES 儿科心脏移植患者的移植物衰竭率、排斥率或住院率无统计学差异。
可能有患者教育、政策和社会资源可以帮助减轻基于 SES 的医疗保健差异。需要更多的多中心研究来确定促进患者公平的移植后护理。