County socioeconomic characteristics and pediatric renal transplantation outcomes

County socioeconomic characteristics and pediatric renal transplantation outcomes Background Existing risk adjustment models for solid organ transplantation omit socioeconomic status (SES). With limited data available on transplant candidates’ SES, linkage of transplant outcomes data to geographic SES measures has been proposed. We investigate the utility of county SES for understanding differences in pediatric kidney transplantation (KTx) outcomes. Methods We identified patients < 18 years of age receiving first-time KTx using United Network for Organ Sharing registry data in two eras: 2006–2010 and 2011–2015, corresponding to periods of county SES data collection. In each era, counties were ranked by 1-year rates of survival with intact graft, and by county SES score. We used Spearman correlation (ρ) to evaluate the association between county rankings on SES and transplant outcomes in each era and consistency between these measures across eras. We also evaluated the utility of county SES for improving prediction of individual KTx outcomes. Results The analysis included 2972 children and 108 counties. County SES and transplant outcomes were not correlated in either 2006–2010 (ρ =0.06; p=0.525)or2011–2015 (ρ =0.162, p = 0.093). County SES rankings were strongly correlated between eras (ρ =0.99, p < 0.001), whereas county rankings of transplant outcomes were not correlated between eras (ρ =0.16, p http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Pediatric Nephrology Springer Journals

County socioeconomic characteristics and pediatric renal transplantation outcomes

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Publisher
Springer Berlin Heidelberg
Copyright
Copyright © 2018 by IPNA
Subject
Medicine & Public Health; Pediatrics; Nephrology; Urology
ISSN
0931-041X
eISSN
1432-198X
D.O.I.
10.1007/s00467-018-3928-0
Publisher site
See Article on Publisher Site

Abstract

Background Existing risk adjustment models for solid organ transplantation omit socioeconomic status (SES). With limited data available on transplant candidates’ SES, linkage of transplant outcomes data to geographic SES measures has been proposed. We investigate the utility of county SES for understanding differences in pediatric kidney transplantation (KTx) outcomes. Methods We identified patients < 18 years of age receiving first-time KTx using United Network for Organ Sharing registry data in two eras: 2006–2010 and 2011–2015, corresponding to periods of county SES data collection. In each era, counties were ranked by 1-year rates of survival with intact graft, and by county SES score. We used Spearman correlation (ρ) to evaluate the association between county rankings on SES and transplant outcomes in each era and consistency between these measures across eras. We also evaluated the utility of county SES for improving prediction of individual KTx outcomes. Results The analysis included 2972 children and 108 counties. County SES and transplant outcomes were not correlated in either 2006–2010 (ρ =0.06; p=0.525)or2011–2015 (ρ =0.162, p = 0.093). County SES rankings were strongly correlated between eras (ρ =0.99, p < 0.001), whereas county rankings of transplant outcomes were not correlated between eras (ρ =0.16, p

Journal

Pediatric NephrologySpringer Journals

Published: Mar 12, 2018

References

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