Rates of solid-organ wait-listing, transplantation, and survival among residents of rural and urban areas
Rates of solid-organ wait-listing, transplantation, and survival among residents of rural and urban areas
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DOI：
10.1001/jama.2007.50
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发表时间：
2008-01-09
影响因子：
120.7
通讯作者：
Merion, Robert M.
中科院分区：
文献类型：
--
作者：
Axelrod, David A.;Guidinger, Mary K.;Merion, Robert M.
少数民族、妇女和社会经济地位较低或保险不足的患者在获得器官移植方面存在差异。农村居民代表了另一个可能损害获得移植服务的群体。目的评估农村居民与心脏、肝脏和肾脏移植的等待名单登记以及等待名单候选人中的移植率之间的关联。设计、设置和患者五年的美国队列，包括174630名等待名单的患者，他们接受了心脏、肝脏、肾脏移植，主要指标3个居住分类居民每百万人口新的等待登记和移植率（农村/小城镇人口，< 10 000;小都市人口，10 000- 50 000;大城市> 5万人或大城市郊区）。农村/小城镇居民的心脏病等候登记率显著较低（协变量校正率比[ RR]= 0.91; 95%可信区间[ Cl]，0.86- 0.96; P
Context Disparities in access to organ transplantation exist for racial minorities, women, and patients with lower socioeconomic status or inadequate insurance. Rural residents represent another group that may have impaired access to transplant services.Objective To assess the association of rural residence with waiting list registration for heart, liver, and kidney transplant and rates of transplantation among wait- listed candidates.Design, Setting, and Patients Five- year US cohort of 174 630 patients who were wait- listed and who underwent heart, liver, or kidney transplantation between 1999 and 2004.Main Outcome Measures Rates of new waiting list registrations and transplants per million population for residents of 3 residential classifications ( rural/ small town population, < 10 000; micropolitan, 10 000- 50 000; and metropolitan > 50 000 or suburb of major city).Results Compared with urban residents, waiting list registration rates for rural/ small town residents were significantly lower for heart ( covariate- adjusted rate ratio [ RR]= 0.91; 95% confidence interval [ Cl], 0.86- 0.96; P