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Individual and neighborhood socioeconomic status in the prediction of liver transplantation among patients with liver disease: A population-based cohort study in Taiwan

Given the fact that >80% of liver transplantations (LTs) were living donor liver transplantation (LDLT) in Taiwan, we conducted this study to assess whether patients with lower socioeconomic status are subject to a lower chance of receiving hepatic transplantation. This was a cohort study includi...

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Autores principales: Liu, Chi-Chu, Lu, Chin-Li, Notobroto, Hari Basuki, Tsai, Chiang-Chin, Wen, Pei-Hung, Li, Chung-Yi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426624/
https://www.ncbi.nlm.nih.gov/pubmed/30882681
http://dx.doi.org/10.1097/MD.0000000000014849
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author Liu, Chi-Chu
Lu, Chin-Li
Notobroto, Hari Basuki
Tsai, Chiang-Chin
Wen, Pei-Hung
Li, Chung-Yi
author_facet Liu, Chi-Chu
Lu, Chin-Li
Notobroto, Hari Basuki
Tsai, Chiang-Chin
Wen, Pei-Hung
Li, Chung-Yi
author_sort Liu, Chi-Chu
collection PubMed
description Given the fact that >80% of liver transplantations (LTs) were living donor liver transplantation (LDLT) in Taiwan, we conducted this study to assess whether patients with lower socioeconomic status are subject to a lower chance of receiving hepatic transplantation. This was a cohort study including 197,082 liver disease patients admitted in 1997 to 2013, who were at higher risk of LT. Personal monthly income and median family income of living areas were used to indicate individual and neighborhood socioeconomic status, respectively. Cox proportional hazard model that considered death as a competing risk event was used to estimate subdistribution hazard ratio (sHR) of LT in association with socioeconomic status. Totally 2204 patients received LT during follow-up, representing a cumulative incidence of 1.12% and an incidence rate of 20.54 per 10(4) person-years. After adjusting for potential confounders, including age, sex, co-morbidity, location/urbanization level of residential areas, we found that patients with < median monthly income experienced significantly lower incidence of LT (aHR = 0.802, 95% confidence interval (CI) = 0.717–0.898), but those with >- median monthly income had significantly elevated incidence of LT (aHR = 1.679, 95% CI = 1.482–1.903), as compared to those who were not actively employed. Additionally, compared to areas with the lowest quartile of median family income, the highest quartile of median family income was also associated with significantly higher incidence rate of LT (aHR = 1.248, 95% CI = 1.055–1.478). Higher individual and neighborhood socioeconomic status were significantly associated with higher incidence of LT among patients with higher risk of LT.
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spelling pubmed-64266242019-04-15 Individual and neighborhood socioeconomic status in the prediction of liver transplantation among patients with liver disease: A population-based cohort study in Taiwan Liu, Chi-Chu Lu, Chin-Li Notobroto, Hari Basuki Tsai, Chiang-Chin Wen, Pei-Hung Li, Chung-Yi Medicine (Baltimore) Research Article Given the fact that >80% of liver transplantations (LTs) were living donor liver transplantation (LDLT) in Taiwan, we conducted this study to assess whether patients with lower socioeconomic status are subject to a lower chance of receiving hepatic transplantation. This was a cohort study including 197,082 liver disease patients admitted in 1997 to 2013, who were at higher risk of LT. Personal monthly income and median family income of living areas were used to indicate individual and neighborhood socioeconomic status, respectively. Cox proportional hazard model that considered death as a competing risk event was used to estimate subdistribution hazard ratio (sHR) of LT in association with socioeconomic status. Totally 2204 patients received LT during follow-up, representing a cumulative incidence of 1.12% and an incidence rate of 20.54 per 10(4) person-years. After adjusting for potential confounders, including age, sex, co-morbidity, location/urbanization level of residential areas, we found that patients with < median monthly income experienced significantly lower incidence of LT (aHR = 0.802, 95% confidence interval (CI) = 0.717–0.898), but those with >- median monthly income had significantly elevated incidence of LT (aHR = 1.679, 95% CI = 1.482–1.903), as compared to those who were not actively employed. Additionally, compared to areas with the lowest quartile of median family income, the highest quartile of median family income was also associated with significantly higher incidence rate of LT (aHR = 1.248, 95% CI = 1.055–1.478). Higher individual and neighborhood socioeconomic status were significantly associated with higher incidence of LT among patients with higher risk of LT. Wolters Kluwer Health 2019-03-15 /pmc/articles/PMC6426624/ /pubmed/30882681 http://dx.doi.org/10.1097/MD.0000000000014849 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Research Article
Liu, Chi-Chu
Lu, Chin-Li
Notobroto, Hari Basuki
Tsai, Chiang-Chin
Wen, Pei-Hung
Li, Chung-Yi
Individual and neighborhood socioeconomic status in the prediction of liver transplantation among patients with liver disease: A population-based cohort study in Taiwan
title Individual and neighborhood socioeconomic status in the prediction of liver transplantation among patients with liver disease: A population-based cohort study in Taiwan
title_full Individual and neighborhood socioeconomic status in the prediction of liver transplantation among patients with liver disease: A population-based cohort study in Taiwan
title_fullStr Individual and neighborhood socioeconomic status in the prediction of liver transplantation among patients with liver disease: A population-based cohort study in Taiwan
title_full_unstemmed Individual and neighborhood socioeconomic status in the prediction of liver transplantation among patients with liver disease: A population-based cohort study in Taiwan
title_short Individual and neighborhood socioeconomic status in the prediction of liver transplantation among patients with liver disease: A population-based cohort study in Taiwan
title_sort individual and neighborhood socioeconomic status in the prediction of liver transplantation among patients with liver disease: a population-based cohort study in taiwan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426624/
https://www.ncbi.nlm.nih.gov/pubmed/30882681
http://dx.doi.org/10.1097/MD.0000000000014849
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