Social adaptability index predicts kidney transplant outcome: a single-center retrospective analysis
Social adaptability index (SAI) is the composite index of socioeconomic status based upon employment status, education level, marital status, substance abuse and income. It has been used in the past to define populations at higher risk for inferior clinical outcomes. The objective of this retrospect...
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Published in | Nephrology, dialysis, transplantation Vol. 27; no. 3; pp. 1239 - 1245 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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Oxford University Press
01.03.2012
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Abstract | Social adaptability index (SAI) is the composite index of socioeconomic status based upon employment status, education level, marital status, substance abuse and income. It has been used in the past to define populations at higher risk for inferior clinical outcomes. The objective of this retrospective study was to evaluate the association of the SAI with renal transplant outcome.
We used data from the clinical database at the Beth Israel Deaconess Medical Center Transplant Institute, supplemented with data from United Network for Organ Sharing for the years 2001-09. The association between SAI and graft loss and recipient mortality in renal transplant recipients was studied using Cox model in the entire study population as well as in the subgroups based on age, race, sex and diabetes status.
We analyzed 533 end-stage renal disease patients (mean age at transplant 50.8 ± 11.8 years, 52.2% diabetics, 58.9% males, 71.1% White). Higher SAI on a continuous scale was associated with decreased risk of graft loss [hazard ratio (HR) 0.89, P < 0.05, per 1 point increment in the SAI] and decreased risk of recipient mortality (HR 0.84, P < 0.01, per 1 point increment in the SAI). Higher SAI was also significantly associated with decreased risk for graft loss/recipient mortality in some study subgroups (age 41-65 years, males, non-diabetics).
SAI has an association with graft and recipient survival in renal transplant recipients. It can be helpful in identifying patients at higher risk for inferior transplant outcome as a target population for potential intervention. |
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AbstractList | BACKGROUNDSocial adaptability index (SAI) is the composite index of socioeconomic status based upon employment status, education level, marital status, substance abuse and income. It has been used in the past to define populations at higher risk for inferior clinical outcomes. The objective of this retrospective study was to evaluate the association of the SAI with renal transplant outcome.METHODSWe used data from the clinical database at the Beth Israel Deaconess Medical Center Transplant Institute, supplemented with data from United Network for Organ Sharing for the years 2001-09. The association between SAI and graft loss and recipient mortality in renal transplant recipients was studied using Cox model in the entire study population as well as in the subgroups based on age, race, sex and diabetes status.RESULTSWe analyzed 533 end-stage renal disease patients (mean age at transplant 50.8 ± 11.8 years, 52.2% diabetics, 58.9% males, 71.1% White). Higher SAI on a continuous scale was associated with decreased risk of graft loss [hazard ratio (HR) 0.89, P < 0.05, per 1 point increment in the SAI] and decreased risk of recipient mortality (HR 0.84, P < 0.01, per 1 point increment in the SAI). Higher SAI was also significantly associated with decreased risk for graft loss/recipient mortality in some study subgroups (age 41-65 years, males, non-diabetics).CONCLUSIONSSAI has an association with graft and recipient survival in renal transplant recipients. It can be helpful in identifying patients at higher risk for inferior transplant outcome as a target population for potential intervention. Social adaptability index (SAI) is the composite index of socioeconomic status based upon employment status, education level, marital status, substance abuse and income. It has been used in the past to define populations at higher risk for inferior clinical outcomes. The objective of this retrospective study was to evaluate the association of the SAI with renal transplant outcome. We used data from the clinical database at the Beth Israel Deaconess Medical Center Transplant Institute, supplemented with data from United Network for Organ Sharing for the years 2001-09. The association between SAI and graft loss and recipient mortality in renal transplant recipients was studied using Cox model in the entire study population as well as in the subgroups based on age, race, sex and diabetes status. We analyzed 533 end-stage renal disease patients (mean age at transplant 50.8 ± 11.8 years, 52.2% diabetics, 58.9% males, 71.1% White). Higher SAI on a continuous scale was associated with decreased risk of graft loss [hazard ratio (HR) 0.89, P < 0.05, per 1 point increment in the SAI] and decreased risk of recipient mortality (HR 0.84, P < 0.01, per 1 point increment in the SAI). Higher SAI was also significantly associated with decreased risk for graft loss/recipient mortality in some study subgroups (age 41-65 years, males, non-diabetics). SAI has an association with graft and recipient survival in renal transplant recipients. It can be helpful in identifying patients at higher risk for inferior transplant outcome as a target population for potential intervention. |
Author | BAIRD, Bradley C PAVLAKIS, Martha SANDHU, Gurprataap S DESILVA, Ranit GARG, Jalaj HONGYING TANG HANTO, Douglas W GOLDFARB-RUMYANTZEV, Alexander S KARIM, Muhammad RODRIGUE, James R |
Author_xml | – sequence: 1 givenname: Jalaj surname: GARG fullname: GARG, Jalaj organization: Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States – sequence: 2 givenname: Muhammad surname: KARIM fullname: KARIM, Muhammad organization: Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States – sequence: 3 surname: HONGYING TANG fullname: HONGYING TANG organization: Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States – sequence: 4 givenname: Gurprataap S surname: SANDHU fullname: SANDHU, Gurprataap S organization: Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States – sequence: 5 givenname: Ranit surname: DESILVA fullname: DESILVA, Ranit organization: Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States – sequence: 6 givenname: James R surname: RODRIGUE fullname: RODRIGUE, James R organization: Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States – sequence: 7 givenname: Martha surname: PAVLAKIS fullname: PAVLAKIS, Martha organization: Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States – sequence: 8 givenname: Douglas W surname: HANTO fullname: HANTO, Douglas W organization: Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States – sequence: 9 givenname: Bradley C surname: BAIRD fullname: BAIRD, Bradley C organization: Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, United States – sequence: 10 givenname: Alexander S surname: GOLDFARB-RUMYANTZEV fullname: GOLDFARB-RUMYANTZEV, Alexander S organization: Division of Nephrology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States |
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Keywords | Kidney disease Urinary system disease Prognosis Hemodialysis Homograft social adaptability index socioeconomic factors allograft loss renal graft outcome Extrarenal dialysis Renal failure Graft transplant |
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SubjectTerms | Adolescent Adult Aged Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Emergency and intensive care: renal failure. Dialysis management Female Health Status Disparities Healthcare Disparities Humans Intensive care medicine Kidney Failure, Chronic - psychology Kidney Failure, Chronic - therapy Kidney Transplantation - mortality Kidney Transplantation - psychology Male Medical sciences Middle Aged Prognosis Retrospective Studies Social Adjustment Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Survival Rate Young Adult |
Title | Social adaptability index predicts kidney transplant outcome: a single-center retrospective analysis |
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