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Pre‐transplant Social Adaptability Index and clinical outcomes in renal transplantation – The Swiss Transplant Cohort Study


Denhaerynck, Kris; Goldfarb‐Rumyantzev, Alexander S; Sandhu, Gurprataap; Beckmann, Sonja; et al; Psychosocial Interest Group; Swiss Transplant Cohort Study (2021). Pre‐transplant Social Adaptability Index and clinical outcomes in renal transplantation – The Swiss Transplant Cohort Study. Clinical Transplantation:Epub ahead of print.

Abstract

Background

The impact of pre‐transplant social determinants of health on post‐transplant outcomes remains understudied. In the US, 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=0.09) for mortality and 0.93 (95%CI: 0.85‐1.02; p=0.15) 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.

Abstract

Background

The impact of pre‐transplant social determinants of health on post‐transplant outcomes remains understudied. In the US, 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=0.09) for mortality and 0.93 (95%CI: 0.85‐1.02; p=0.15) 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.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Thoracic Surgery
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Transplantation
Language:English
Date:6 January 2021
Deposited On:11 Feb 2021 08:24
Last Modified:04 Mar 2021 16:51
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0902-0063
OA Status:Closed
Publisher DOI:https://doi.org/10.1111/ctr.14218
PubMed ID:33406303

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