在缺乏服务的西班牙裔社区获得移植的地理空间洞察
Stalin Cañizares1, Bruna Trindade2, Gabriel Cojuc-Konigsberg3
1Division of Transplant Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Journal of racial and ethnic health disparities
|August 27, 2025
概括
在西班牙裔末期病患者接受移植方面,仍存在地理差异. 需要有针对性的外展和新的中心来服务ESKD的弱势西班牙裔人口.
科学领域:
- 肝脏病学
- 公共卫生
- 医疗服务研究
背景情况:
- 美国越来越多的西班牙裔人口面临着晚期病 (ESKD) 的重大风险.
- 对于西班牙裔社区来说,
- 对于西班牙裔ESKD患者来说,确定对移植中心 (KTC) 访问有限的地区至关重要.
研究的目的:
- 确切地确定美国地理区域有高患ESKD的西班牙裔个人,
- 评估西班牙裔脏诊所 (H-KTC) 对移植率的影响.
主要方法:
- 使用UNOS数据库 (2018-2022) 来定位KTC.
- 对西班牙裔个人 (2021 USRDS) 的县级ESKD患病率和死亡率数据进行分析.
- 进行了地理空间分析,以确定西班牙裔人口与KTC的距离,并确定了ESKD流行率和死亡率的空间集群.
主要成果:
- 西班牙裔患有ESKD的比例更高,居住在KTC的2小时车程之外 (0.23%对比0.21%).
- 西班牙裔ESKD患者的死亡率在2小时驾驶区以外更高 (11.4%对10.2%),西南地区的死亡率较高.
- 实施H-KTC导致西班牙裔接受者中位数移植显著增加 (81到109,p=0.006).
结论:
- 现有的KTC位于战略位置,但西班牙裔ESKD人群的访问仍然存在重大差距.
- 在西班牙裔ESKD患病率很高但KTC接入有限的地区,需要集中宣传.
- 建议通过新的或现有的KTC扩展服务,以改善服务不足的西班牙裔社区的移植机会.
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