在透析设施之间设定对移植转诊的合理目标
Jessica L Harding1,2,3,4, Meredith A Dixon5, Mengyu Di6
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. Jessica.harding@emory.edu.
BMC nephrology
|July 25, 2024
概括
许多符合移植资格的末期病患者没有被转诊. 将转诊率提高约14%,可以显著增加接受救命移植的患者数量.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植手术 移植手术
- 公共卫生 公共卫生
背景情况:
- 移植资格评估是复杂的.
- 很大一部分末期病 (ESKD) 患者可能不会被转诊进行移植.
- 这项研究估计了ESKD患者的比例,这些患者没有被转诊,但可能是合适的移植候选人.
研究的目的:
- 估计末期病患者 (ESKD) 的比例,这些患者没有被转诊接受移植,但可能是合适的候选人.
- 识别移植转诊过程中的潜在障碍或缺口.
- 为增加移植转诊的策略提供信息.
主要方法:
- 分析了2012-2017年间在乔治亚州,北卡罗来纳州和南卡罗来纳州开始透析的43,952名患者.
- 连接美国脏数据系统数据与早期步骤到移植访问注册表.
- 使用倾向性得分切线,后勤回归和AUC来识别"良好的移植候选人"未提及.
主要成果:
- 总体而言,42.6%的事件透析患者在一年内被转诊;32.9%的转诊者在两年内被列入等待名单.
- 识别良好的移植候选人的模型显示出合理的歧视 (AUC=0.70).
- 据估计,未被转诊的患者中有25%可能是好的移植候选人,这意味着整体转诊率可能增加14.6%.
结论:
- 很大一部分可能适合的移植候选人没有被转诊.
- 将透析设施的转诊率提高约14%,这是一个现实的和有意义的目标.
- 改善转诊实践可以导致更合格的患者被列入移植等待名单.
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