News: SDOH indices bear strong connection to U.S. lung transplant outcomes, study shows

Patient demographic and socioeconomic status strongly correlate with access to the United States lung transplant system, according to a new study.

The study, published in JAMA Network Open, examined 30,050 U.S. patients with obstructive and restrictive lung diseases in the primary care setting, 73,817 patients engaged in a pulmonary medicine encounter, 4,198 patients undergoing lung transplant evaluation, and 1,378 patients placed on the lung transplant list.

Using advanced statistical analyses, demographic and geographic data, and socioeconomic indices, the researchers developed what they referred to as an area deprivation index (ADI), which allowed them to gauge how accessible medical resources were in each area.

From there, the researchers divided the patients into four distinct cohorts and cross referenced each patient’s ADI with their clinical outcomes.

The most significant conclusions were as follows:

• Cohort 1: Primary care patients with obstructive or restrictive lung disease: Patients in the least-resourced ADI quintile—that is, those with the lowest accessibility to medical resources in a given geographical area—were 97% more likely to die before accessing pulmonary medicine compared to those in the most-resourced ADI quintile. The least-resourced ADI quintile was also 55% likelier to relapse and had a 13% lower rate of progressing to pulmonary medicine.
• Cohort 2: Pulmonary medicine patients: Patients in the least-resourced ADI quintile were 90% more likely to die before reaching a lung transplant evaluation compared to those in the most-resourced ADI quintile and had a 69% increased likelihood of successfully transitioning to lung transplant evaluation.
• Cohort 3: Patients undergoing lung transplant evaluation: Patients in the least-resourced ADI quintile were 40% more likely to die prior to placement on the waiting list compared to those in the most-resourced ADI quintile and were 45% less likely to be placed on the waiting list.
• Cohort 4: Patients on the waiting list: Despite experiencing a similar transplant rate, patients in the least-resourced ADI quintile were 97% more likely to die prior to transplant compared to patients in the most-resourced ADI quintile.

Editor’s note: To read the JAMA study, click here.