Pre-transplant Social Adaptability Index and clinical outcomes in renal transplantation: The Swiss Transplant Cohort study
- PMID: 33406303
- DOI: 10.1111/ctr.14218
Pre-transplant Social Adaptability Index and clinical outcomes in renal transplantation: The Swiss Transplant Cohort study
Abstract
Background: The impact of pre-transplant social determinants of health on post-transplant outcomes remains understudied. In the United States, poor clinical outcomes are associated with underprivileged status, as assessed by the Social Adaptability Index (SAI), a composite score of education, employment status, marital status, household income, and substance abuse. Using data from the Swiss Transplant Cohort Study (STCS), we determined the SAI's predictive value regarding two post-transplant outcomes: all-cause mortality and return to dialysis.
Methods: Between 2012 and 2018, we included adult renal transplant patients (aged ≥ 18 years) with pre-transplant assessment SAI scores, calculated from a STCS Psychosocial Questionnaire. Time to all-cause mortality and return to dialysis were predicted using Cox regression.
Results: Of 1238 included patients (mean age: 53.8 ± 13.2 years; 37.9% female; median follow-up time: 4.4 years [IQR: 2.7]), 93 (7.5%) died and 57 (4.6%) returned to dialysis. The SAI's hazard ratio was 0.94 (95%CI: 0.88-1.01; p = .09) for mortality and 0.93 (95%CI: 0.85-1.02; p = .15) for return to dialysis.
Conclusions: In contrast to most published studies on social deprivation, analysis of this Swiss sample detected no significant association between SAI score and mortality or return to dialysis.
Keywords: graft survival; kidney transplantation; mortality; socioeconomic factors.
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
References
REFERENCES
-
- Centers for Disease Control and Prevention. Social determinants of health. https://www.cdc.gov/nchhstp/socialdeterminants/index.html. Accessed May 18, 2020.
-
- Marmot M, Friel S, Bell R, Houweling TA, Taylor S. Commission on social determinants of H. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372:1661-1669.
-
- Patzer RE, Perryman JP, Schrager JD, et al. The role of race and poverty on steps to kidney transplantation in the Southeastern United States. Am J Transplant. 2012;12:358-368.
-
- Tjaden LA, Noordzij M, van Stralen KJ, et al. Racial disparities in access to and outcomes of kidney transplantation in children, adolescents, and young adults: results from the ESPN/ERA-EDTA (European Society of Pediatric Nephrology/European Renal Association-European Dialysis and Transplant Association) registry. Am J Kidney Dis. 2016;67:293-301.
-
- Monson RS, Kemerley P, Walczak D, Benedetti E, Oberholzer J, Danielson KK. Disparities in completion rates of the medical prerenal transplant evaluation by race or ethnicity and gender. Transplantation. 2015;99:236-242.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical

