造血细胞移植幸存者的驾车距离和患者报告的预后

Rahul Banerjee , Jean C. Yi , Navneet S. Majhail , Heather S.L. Jim , Joseph Uberti , Victoria Whalen , Alison W. Loren , Karen L. Syrjala
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引用次数: 11

摘要

距离移植中心较远的驾驶距离可能会阻碍造血细胞移植(HCT)幸存者获得护理。作为多中心INSPIRE研究(NCT01602211)的辅助分析,我们检查了无复发HCT成年幸存者(同种异体或自体HCT后2至10年)的基线数据,以调查驾驶距离与患者报告的痛苦和身体功能测量结果(PRO)之间的关系。我们使用逻辑回归模型分析了焦虑加剧和身体功能受损的预测因素,该模型首先将驾驶距离作为一个连续变量,然后将其单独作为一个二分类变量(<100与100+英里)。在美国6个中心的1136例可用于分析的患者中,平均驾驶距离为82英里,44%的患者居住在距离HCT中心100英里以上的地方。32%的患者报告焦虑加剧,19%的患者报告身体功能受损,两者均为12%。在线性回归模型中,无论是作为连续变量还是二分类变量,驾驶距离对焦虑或身体功能都没有影响(95%置信区间为1.00 ~ 1.00,两个PROs都将驾驶距离作为连续变量)。相比之下,慢性移植物抗宿主病、较低的收入和缺乏互联网接入独立地预测了痛苦加剧和身体功能受损。总之,我们发现驾驶距离对HCT幸存者的痛苦和身体功能没有影响。我们的研究结果对HCT后的长期随访护理提供了影响,考虑到驾驶距离对PROs的可忽略不计的影响,以及没有互联网接入的HCT幸存者的“数字鸿沟”恶化结果的风险。
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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Driving Distance and Patient-Reported Outcomes in Hematopoietic Cell Transplantation Survivors

Long driving distances to transplantation centers may impede access to care for hematopoietic cell transplantation (HCT) survivors. As a secondary analysis from the multicenter INSPIRE study (NCT01602211), we examined baseline data from relapse-free HCT adult survivors (2 to 10 years after allogeneic or autologous HCT) to investigate the association between driving distances and patient-reported outcome (PRO) measures of distress and physical function. We analyzed predictors of elevated distress and impaired physical function using logistic regression models that operationalized driving distance first as a continuous variable and separately as a dichotomous variable (<100 versus 100+ miles). Of 1136 patients available for analysis from 6 US centers, median driving distance was 82 miles and 44% resided 100+ miles away from their HCT centers. Elevated distress was reported by 32% of patients, impaired physical function by 19%, and both by 12%. Driving distance, whether operationalized as a continuous or dichotomous variable, had no impact on distress or physical function in linear regression modeling (95% confidence interval, 1.00 to 1.00, for both PROs with driving distance as a continuous variable). In contrast, chronic graft-versus-host-disease, lower income, and lack of Internet access independently predicted both elevated distress and impaired physical function. In summary, we found no impact of driving distance on distress and physical function among HCT survivors. Our results have implications for how long-term follow-up care is delivered after HCT, with regard to the negligible impact of driving distances on PROs and also the risk of a “digital divide” worsening outcomes among HCT survivors without Internet access.

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来源期刊
CiteScore
6.60
自引率
0.00%
发文量
1061
审稿时长
3-6 weeks
期刊介绍: Biology of Blood and Marrow Transplantation publishes original research reports, reviews, editorials, commentaries, letters to the editor, and hypotheses and is the official publication of the American Society for Transplantation and Cellular Therapy. The journal focuses on current technology and knowledge in the interdisciplinary field of hematopoetic stem cell transplantation.
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