|Lower Socioeconomic Status Is Associated with Worse Outcomes in Pulmonary Arterial Hypertension|
|Wu, Wen-Hui1; Yang, Lu1; Peng, Fu-Hua1; Yao, Jing1; Zou, Li-Ling2; Liu, Dong1; Jiang, Xin1; Li, Jue2; Gao, Lan3; Qu, Jie-Ming4,5; Kawut, Steven M.6,7; Jing, Zhi-Cheng1|
|关键词||Pulmonary Arterial Hypertension Socioeconomic Status Survival|
|刊名||AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE|
|收录类别||SCI ; SSCI|
|WOS标题词||Science & Technology|
|类目[WOS]||Critical Care Medicine ; Respiratory System|
|研究领域[WOS]||General & Internal Medicine ; Respiratory System|
|关键词[WOS]||HEALTH SYSTEM REFORM ; CARDIOVASCULAR-DISEASE ; CHINESE PATIENTS ; RISK-FACTORS ; HEART-DISEASE ; MORTALITY ; DEPRESSION ; CARE ; SURVIVAL ; ANXIETY|
Rationale: Lower socioeconomic status (SES) confers a heightened risk of common cardiovascular and pulmonary diseases and increased mortality. The association of SES with outcomes in patients with pulmonary arterial hypertension (PAH) is less clear.
Objectives: To determine the association between SES and outcomes in patients with PAH.
Methods: We performed a prospective cohort study at a national referral center for patients with PAH in China. Two hundred sixty-two consecutive incident patients aged 18 to 65 years with a diagnosis of idiopathic PAH were recruited between January 2007 and June 2011 and followed up until November 2011. The primary endpoint was all-cause mortality. An SES score for each patient was derived from their educational level, annual household income, occupation, and medical reimbursement rate.
Measurements and Main Results: Patients with a lower SES had higher unadjusted mortality rates, with 3-year survival estimates of 50.1, 70.8, and 86.0% in increasing tertiles of SES (P for trend < 0.001). After adjustment for clinical features, hemodynamics, and type of PAH treatment, the hazard ratios for death were 2.98 (95% confidence interval, 1.51-5.89) in the lowest tertile of SES and 1.80 (95% confidence interval, 0.89-3.63) in the middle tertile of SES compared with the upper tertile (P for trend = 0.006).
Conclusions: A lower SES is strongly associated with a higher risk of death in idiopathic PAH. This association was independent of clinical characteristics, hemodynamics, and treatment Addressing the health disparities associated with a lower SES may improve the outcomes of patients with PAH.
|项目编号||DPSEC-10SG25 ; NCET-10-0630 ; shdc-12010102 ; 09ZZ35 ; K24 HL103844|
|资助机构||Program for Shanghai Outstanding Academic Leader ; "Dawn" Program of Shanghai Education Committee ; Program of New Century Excellent Talents in University ; Shen Kang Major Joint Research Project on Emerging Technology in Municipal Hospital ; Innovation Program of Shanghai Municipal Education Commission ; National Institutes of Health|
|作者单位||1.Shanghai Municipal Hlth Bur, Shanghai, Peoples R China|
2.Tongji Univ, Sch Med, Shanghai Pulm Hosp, Dept Cardiopulm Circulat, Shanghai 200433, Peoples R China
3.Tongji Univ, Sch Med, Dept Prevent Med, Shanghai 200433, Peoples R China
4.Beijing Univ, Hlth Sci Ctr, Hosp 1, Dept Rheumatol, Beijing 100871, Peoples R China
5.Fudan Univ, Dept Resp Med, Huadong Hosp, Shanghai 200433, Peoples R China
6.Univ Penn, Dept Med, Perelman Sch Med, Philadelphia, PA 19104 USA
7.Univ Penn, Dept Epidemiol, Perelman Sch Med, Philadelphia, PA 19104 USA
|Wu, Wen-Hui,Yang, Lu,Peng, Fu-Hua,et al. Lower Socioeconomic Status Is Associated with Worse Outcomes in Pulmonary Arterial Hypertension[J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE,2013,187(3):303-310.|
|APA||Wu, Wen-Hui.,Yang, Lu.,Peng, Fu-Hua.,Yao, Jing.,Zou, Li-Ling.,...&Jing, Zhi-Cheng.(2013).Lower Socioeconomic Status Is Associated with Worse Outcomes in Pulmonary Arterial Hypertension.AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE,187(3),303-310.|
|MLA||Wu, Wen-Hui,et al."Lower Socioeconomic Status Is Associated with Worse Outcomes in Pulmonary Arterial Hypertension".AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 187.3(2013):303-310.|