Patient factors associated with lung transplant referral and waitlist for patients with cystic fibrosis and pulmonary fibrosis
| Autor: | Edward R. Garrity, Milda R. Saunders, Christopher H. Wigfield, Monica B. Vela, Yuan Liu, Tanya M Rudakevych |
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| Rok vydání: | 2017 |
| Předmět: |
Graft Rejection
Male Cystic Fibrosis Pulmonary Fibrosis Comorbidity Kaplan-Meier Estimate 030230 surgery Severity of Illness Index Cystic fibrosis Insurance Coverage Cohort Studies 0302 clinical medicine Pulmonary fibrosis Referral and Consultation Depression (differential diagnoses) Academic Medical Centers Graft Survival Middle Aged Respiratory Function Tests Anxiety Female medicine.symptom Cardiology and Cardiovascular Medicine Lung Transplantation Adult Pulmonary and Respiratory Medicine medicine.medical_specialty Waiting Lists Referral Risk Assessment Statistics Nonparametric Article 03 medical and health sciences Internal medicine medicine Humans Retrospective Studies Transplantation business.industry Patient Selection Retrospective cohort study medicine.disease Survival Analysis United States 030228 respiratory system Physical therapy Surgery business Body mass index Lung allocation score |
| Zdroj: | The Journal of Heart and Lung Transplantation. 36:264-271 |
| ISSN: | 1053-2498 |
| DOI: | 10.1016/j.healun.2016.08.016 |
| Popis: | BACKGROUND: Since 2005, the Lung Allocation Score (LAS) has prioritized patient benefit and post-transplant survival, reducing waitlist to transplant time to less than 200 days and decreasing mortality on the waitlist. A current challenge is the wait for the waitlist—the time between patient’s transplant-eligible diagnosis and waitlist registration. METHODS: We investigated whether sociodemographic (age, sex, race, insurance, marital status, median household income) and clinical (FEV(1) % of predicted, body mass index, depression/anxiety, alcohol/substance misuse, absolute/relative contraindications) factors influenced referral and waitlist registration. We conducted a retrospective cohort study through chart review of hospitalized patients on the University of Chicago general medicine service from 2006–2014 meeting transplant-eligible criteria and ICD-9 billing codes for cystic fibrosis (CF) and pulmonary fibrosis (PF). We analyzed the times from transplant-eligibility to referral, work-up, and waitlist using Kaplan-Meier curves and log-rank tests. RESULTS: Overall, referral rates for transplant-eligible patients were 64%. Of those referred, approximately 36% reach the lung transplant waitlist. Referred CF patients were significantly more likely to reach the transplant waitlist than PF patients (CF 60% vs. PF 22%, p |
| Databáze: | OpenAIRE |
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