基于种族的螺旋测值的历史使用降低了黑人患者的移植优先级
Daniel Colon Hidalgo1, Kathleen J Ramos2, Emily A Harlan3
1Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO.
Chest
|October 13, 2023
概括
用于肺部分配得分 (LAS) 的基于种族的螺旋测量方程不公平地增加了等待肺移植的黑人患者的等待时间. 这项研究强调了这些种族特定的配方如何加剧肺移植现有的差异.
科学领域:
- 肺部医学 肺部医学
- 移植科学 移植科学
- 健康 公平 研究 健康 公平 研究
背景情况:
- 肺部分配分数 (LAS) 对于优先考虑肺部移植候选人至关重要.
- 螺旋测量数据,包括FVC,用于LAS计算间歇性肺部疾病 (ILD).
- 现有的螺旋测量种族特定方程可能会影响LAS得分,但其影响尚不清楚.
研究的目的:
- 调查基于种族的螺旋测量方程是否会导致寻求肺移植的黑人患者等待时间更长.
- 评估种族特定方程对LAS得分和移植等候名单持续时间的影响.
主要方法:
- 在2005年至2020年期间,对33845名患者进行了回顾性分析,这些患者被列为肺移植患者.
- 用白人特异性螺旋计方程重新计算黑人患者的LAS得分.
- 评估这些重新计算对等待名单时间的影响.
主要成果:
- 患有ILD的黑人患者在使用白人特定方程时,LAS得分增加了1.9个点.
- 这种得分增加转化为黑人患者的等待列表时间更长.
- 分析显示存在差异,白人患者的LAS分数较低,接受移植的频率更高.
结论:
- 在LAS计算中使用特定种族的螺旋测量方程使黑人患者处于不利地位,导致延长等待时间.
- 这些基于种族的方程扩大了肺移植获取和结果的现有差异.
- 在LAS中对螺旋计方程的重新评估对于公平的器官分配至关重要.
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