A comparison of outcomes after lung transplantation between European and North American centers.
A comparison of outcomes after lung transplantation between European and North American centers.
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DOI：
10.1016/j.healun.2022.07.014
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发表时间：
2022-12
影响因子：
8.9
通讯作者：
Puri, Varun
中科院分区：
文献类型：
--
作者：
Yang, Zhizhou;Takahashi, Tsuyoshi;Terada, Yuriko;Meyers, Bryan F.;Kozower, Benjamin D.;Patterson, G. Alexander;Nava, Ruben G.;Hachem, Ramsey R.;Witt, Chad A.;Byers, Derek E.;Kulkarni, Hrishikesh S.;Guillamet, Rodrigo Vazquez;Yan, Yan;Chang, Su-Hsin;Kreisel, Daniel;Puri, Varun
随着基础科学和临床医学的进步，肺移植（LT）在过去三十年中发展迅速。然而，目前尚不清楚是否存在显着的区域差异，在长期的结果后LT。为了研究潜在的差异，我们比较了欧洲和北美LT中心之间的总生存期（OS）的倾向评分匹配分析。在3，115对匹配良好的患者中，尽管两组患者的30天生存率相似（NA 96.2% vs.欧洲95.4%，P=0.116），但欧洲患者的5年生存率显著较高（NA 60.1% vs.欧洲70.3%，P<0.001）。这种生存差异在排除加拿大患者的敏感性分析中持续存在。先前的观察表明，这些差异至少部分与通过欧洲流行的全民医疗保健模式更好地获得护理有关。未来的研究有必要证实我们的发现并探索其他因果机制。潜在的解决方案可能需要医疗保健提供者和政策制定者的共同努力。
With advancements in basic science and clinical medicine, lung transplantation (LT) has evolved rapidly over the last three decades. However, it is unclear if significant regional variations exist in long-term outcomes after LT. To investigate potential differences, we compared overall survival (OS) between European and North American LT centers in a propensity score matched analysis. In 3,115 well-matched pairs, though 30-day survival was similar between groups (NA 96.2% vs. Europe 95.4%, P=0.116), 5-year survival was significantly higher in European patients (NA 60.1% vs. Europe 70.3%, P<0.001). This survival difference persisted in a sensitivity analysis excluding Canadian patients. Prior observations suggest that these disparities are at least partly related to better access to care via universal healthcare models prevalent in Europe. Future studies are warranted to confirm our findings and explore other causal mechanisms. It is likely that potential solutions will require concerted efforts from healthcare providers and policymakers.
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