在西班牙裔患者中仍然存在差异:完成评估,等待名单和接受脏移植
Elisa J Gordon1, Jungwha Lee2, Raymond Kang3
1Department of Surgery, and Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN.
Transplantation direct
|February 28, 2024
概括
与非西班牙裔白人患者相比,西班牙裔患者在脏移植 (KT) 中面临重大障碍,经历了较低的批准,等待名单和接收率. 解决这些差异对于公平获得拯救生命的知识技术至关重要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 移植手术 移植手术
- 医疗保健服务研究 医疗服务研究
背景情况:
- 移植 (KT) 是末期病的关键治疗方法.
- 与非西班牙裔白人 (NHW) 患者相比,西班牙裔患者接受移植的次数较少.
- 在西班牙裔人口中获得KT评估步骤的差异需要调查.
研究的目的:
- 评估西班牙裔患者在完成移植 (KT) 评估步骤中的差异.
- 为了比较西班牙裔和NHW患者在KT评估过程中达到每个阶段的风险.
主要方法:
- 在四个移植中心 (2011年1月 - 2020年3月) 使用5197名患者 (西班牙裔和NHW) 的医疗记录进行观察性研究.
- 使用顺序的考克斯模型来比较通过KT评估里程碑的进展.
- 分析的重点是比较西班牙裔与NHW患者在每个步骤:KP委员会批准,等待列表和KT接收.
主要成果:
- 西班牙裔患者的KP委员会批准风险明显较低 (aHR,0.92;P=0.015).
- 西班牙裔患者在批准后被列入等待名单的可能性降低了 (aHR,0.87;P=0.004).
- 西班牙裔患者接受KT的风险较低 (aHR,0.89;P=0.011),达到KT的风险总体较低16% (aHR,0.84;P=0.0002).
结论:
- 西班牙裔患者在移植 (KT) 评估过程的多个阶段遇到重大差异.
- 与NHW患者相比,越来越少的西班牙裔患者被KP委员会批准,列在等待名单上,并最终接受KT.
- 建议加强对KT评估途径的监督,以减轻西班牙裔患者的访问挑战.
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