Health literacy and cumulative social disadvantage are associated with survival and transplant in patients with hepatocellular carcinoma: a prospective study.

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY BMJ Open Gastroenterology Pub Date : 2024-10-02 DOI:10.1136/bmjgast-2024-001537

Lauren D Nephew, Susan M Rawl, Allie Carter, Nicole Garcia, Patrick O Monahan, John Holden, Marwan Ghabril, Eleazar Montalvan-Sanchez, Kavish Patidar, Archita P Desai, Eric Orman, Naga Chalasani

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Abstract

Objective: To investigate how individual social determinants of health (SDOH) and cumulative social disadvantage (CSD) affect survival and receipt of liver transplant (LT) in patients with hepatocellular carcinoma (HCC).

Methods: We enrolled 139 adult patients from two Indianapolis hospital systems between June 2019 and April 2022. Structured questionnaires collected SDOH and social risk factor data. We compared SDOH and CSD by race, gender and disease aetiology, assigning one point per adverse SDOH. Multivariable competing risk survival analysis assessed associations between SDOH, CSD, survival and LT receipt.

Results: Black patients experienced higher CSD than white patients in the cohort (5.4±2.5 vs 3.2±2.1, p<0.001). Black patients were significantly more likely to have household incomes

Conclusions: There are significant racial and aetiology-related differences in SDOH burden. Low health literacy and high CSD are linked to worse outcomes in HCC patients. Health literacy screening and targeted interventions for those with high CSD could improve LT access and survival rates.

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肝细胞癌患者的健康素养和累积性社会劣势与生存和移植相关：一项前瞻性研究。

目的研究个人健康社会决定因素（SDOH）和累积性社会不利条件（CSD）如何影响肝细胞癌（HCC）患者的生存和接受肝移植（LT）：我们在 2019 年 6 月至 2022 年 4 月期间从印第安纳波利斯的两家医院系统招募了 139 名成年患者。结构化问卷收集了 SDOH 和社会风险因素数据。我们按种族、性别和疾病病因对 SDOH 和 CSD 进行了比较，对每个不利的 SDOH 给予一个点。多变量竞争风险生存分析评估了SDOH、CSD、生存和接受LT之间的关联：结果：在队列中，黑人患者的CSD高于白人患者（5.4±2.5 vs 3.2±2.1，p结论：黑人患者的CSD高于白人患者（5.4±2.5 vs 3.2±2.1，p结论）：SDOH负担存在明显的种族和病因差异。低健康素养和高 CSD 与 HCC 患者较差的预后有关。对高 CSD 患者进行健康素养筛查并采取有针对性的干预措施，可提高接受长期治疗的机会和存活率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

5.90

自引率

3.20%

发文量

审稿时长

2 weeks

期刊介绍： BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.