Race affects outcome among infants with intestinal failure.
Race affects outcome among infants with intestinal failure.
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DOI：
10.1097/mpg.0000000000000456
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发表时间：
2014-10
影响因子：
2.9
通讯作者：
Pediatric Intestinal Failure Consortium
中科院分区：
文献类型：
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作者：
Squires RH;Balint J;Horslen S;Wales PW;Soden J;Duggan C;Li R;Belle SH;Pediatric Intestinal Failure Consortium
肠衰竭是一种罕见的破坏性疾病，与显著的发病率和死亡率有关。我们试图确定种族和种族差异是否与患者存活率和接受肠道移植的可能性有关，在当代的肠衰竭儿童队列中。这是一项多中心队列研究的分析，数据收集自儿科肠道联盟(PIFCon)进行的图表回顾。进入标准包括婴儿和12个月接受肠外营养(PN)，连续60天，并跟踪至少2年。结果包括死亡和肠道移植(ITX)。种族和民族被记录在医疗记录中。出于统计比较和回归建模的目的，种族类别被合并为“白人”和“非白人”儿童。在272名受试者中，204名白人儿童和46名非白人儿童可供分析。无ITX死亡的48个月累积发病概率非白人为0.40，白人为0.16(p<；0.001)，非白人为0.07，白人为0.31(p=0.003)。在考虑了低出生体重、诊断和在移植中心被看到后，种族和结果之间的关联仍然存在。在一大批肠衰竭儿童中，种族与死亡和接受ITX有关。这项研究强调了调查肠衰竭儿童预后中明显的种族差异的原因的必要性。
Intestinal failure is a rare, devastating condition associated with significant morbidity and mortality. We sought to determine if ethnic and racial differences were associated with patient survival and likelihood of receiving an intestinal transplant in a contemporary cohort of children with intestinal failure. This was an analysis of a multicenter cohort study with data collected from chart review conducted by the Pediatric Intestinal Consortium (PIFCon). Entry criteria included infants < 12 mo receiving parenteral nutrition (PN) for > 60 continuous days and followed for at least 2 years. Outcomes included death and intestinal transplant (ITx). Race and ethnicity were recorded as they were in the medical record. For purposes of statistical comparisons and regression modeling, categories of race were consolidated into “white” and “non-white” children. Of 272 subjects enrolled, 204 white and 46 non-white children were available for analysis. The 48 month cumulative incidence probability (CIP) of death without ITx was 0.40 for non-white and 0.16 for white children (p<0.001); the CIP of ITx was 0.07 for non-white vs 0.31 for white children (p=0.003). The associations between race and outcomes remained after accounting for low-birth weight, diagnosis, and being seen at a transplant center. Race is associated with death and receiving an ITx in a large cohort of children with intestinal failure. This study highlights the need to investigate reasons for this apparent racial disparity in outcome among children with intestinal failure.