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学科主题: 临床医学
题名:
Lower Socioeconomic Status Is Associated with Worse Outcomes in Pulmonary Arterial Hypertension
作者: 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
发表日期: 2013-02-01
DOI: 10.1164/rccm.201207-1290OC
卷: 187, 期:3, 页:303-310
收录类别: SCI ; SSCI
文章类型: Article
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
英文摘要:

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.

语种: 英语
所属项目编号: DPSEC-10SG25 ; NCET-10-0630 ; shdc-12010102 ; 09ZZ35 ; K24 HL103844
项目资助者: 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
WOS记录号: WOS:000314860700012
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/53220
Appears in Collections:北京大学第一临床医学院_风湿免疫科_期刊论文

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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

Recommended Citation:
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.
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