儿童预防性脏移植率的社会经济差异
Sarah Kizilbash1, Chung-Ii Wi2, Madison Roy3
1Department of Pediatrics University of Minnesota.
Kidney360
|April 7, 2025
概括
具有较低社会经济地位 (SES) 的儿童接受预防性移植的几率明显较低. 这突显了儿科移植的差异,影响了生存效益.
科学领域:
- 儿科脏病学 儿科脏病学
- 移植医学 移植医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 与透析后移植相比,儿童的预防性移植改善了结果.
- 预防性儿科移植率仍然低于最佳水平.
- 社会经济地位 (SES) 可能会影响获得预防性移植.
研究的目的:
- 研究个人社会经济地位 (SES) 与儿童预防性移植之间的关联.
- 评估较低的SES是否与预防性儿科脏移植率的降低有关.
主要方法:
- 在2010-2020年间移植的173名儿科脏移植接受者 (<18岁) 的回顾性分析.
- 使用了HOUSES指数,该指数是基于住房单位的个人SES的验证度量,分为四分位数 (Q1:较低的SES;Q2-Q4:较高的SES).
- 应用混合效应的多变量物流模型,以评估 HOUSES 对预防性移植和移植前透析持续时间的影响,并对共变量进行调整.
主要成果:
- 在173名接受者中,有46人 (26.6%) 接受了预防性移植.
- 较低的SES (Q1) 与较高的SES (Q2-4) 相比,与接受预防性移植的几率较低显著相关 (调整的几率比率[aOR]:0.31;95% CI:0.11,0.90;p=0.03),经过关键因素的调整后.
- 在具有透析数据的109名接受者中,35.8%的透析持续时间超过一年.
结论:
- 在儿童中预防性移植率存在显著的社会经济差异.
- HOUSES指数有效地确定了较低的SES作为儿童脏移植接受者预防性移植的障碍.
- 解决社会经济因素对于改善儿童获得预防性移植的平等机会至关重要.
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