Evidence map›Paper›PMID 29557046›Full record

ArticleJournal of racial and ethnic health disparities2018

Evolving Trends in Racial Disparities for Peri-Operative Outcomes with the New Kidney Allocation System (KAS) Implementation.

Daisy Sanchez, Derek Dubay, Baliga Prabhakar, David J Taber

Abstract read
In one paragraph

Article in Journal of racial and ethnic health disparities, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Daisy SanchezCollege of Medicine, MUSC, Charleston, SC, 29425, USA. sanched@musc.edu.ORCID 0000-0001-8616-2833
Derek DubayDepartment of Transplant Surgery, MUSC, Charleston, SC, USA.
Baliga PrabhakarCollege of Medicine, MUSC, Charleston, SC, 29425, USA.
David J TaberDepartment of Transplant Surgery, MUSC, Charleston, SC, USA.

Funding

SHORT-TERM TRAINING IN HEALTH PROFESSIONAL SCHOOLST35DK007431 · NIDDK · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI LACKLAND, DANIEL T · 1990 to 2019
$2.1M
Impact of Cardiovascular Risk Control on Racial Disparities in Kidney TransplantK23DK099440 · NIDDK · MEDICAL UNIVERSITY OF SOUTH CAROLINA · PI TABER, DAVID J. · 2014 to 2017
$715k
NIDDK NIH HHS K23 DK099440NIDDK NIH HHS T35 DK007431
6 · The paper itself

Abstract

introductionTo improve kidney transplant allocation equitability, a new Kidney Allocation System (KAS) was implemented December 4, 2014. The purpose of this study was to determine if the impact of KAS on peri-operative outcomes differed by recipient race/ethnicity.

methodsThis was a time series analysis using data aggregated in monthly intervals from October 2012 through September 2015 using the University HealthSystem Consortium (UHC). This includes national data aggregated at the center level of all US kidney transplant centers that participate in the UHC (416 centers). Segmented regression with interaction terms was used to determine the impact of KAS on outcomes and differences by race/ethnicity.

resultsA total of 28,809 deceased donor kidney transplants were included with 25 months of pre-KAS data and 10 months of post-KAS data. After KAS implementation, the estimated transplant rate per month decreased significantly for Caucasians by 17.6 cases per month (p = 0.0001), and increased significantly for AAs by 37.8 (p = 0.0001), Hispanics by 16.3 (p = 0.0001), and other races by 8.2 cases per month (p = 0.0001). Delayed graft function, 7- and 14-day readmissions significantly increased after KAS, which did not differ by race. Hispanics saw a 7.7% decrease in ICU admissions after KAS, which differed as compared to other racial/ethnic cohorts (p = 0.0026). Costs of kidney transplantation increased significantly after KAS in all groups except Hispanics. Mortality, length of stay, in-hospital complications, and 30-day readmissions were not significantly impacted by KAS, also not differing by race/ethnicity.

conclusionKAS had substantial impact on transplant rates by race/ethnicity. KAS also led to increased costs, readmissions, and delayed graft function (DGF) across all racial/ethnic groups. The impact of KAS on ICU cases solely within Hispanics requires further investigation into potential etiologies.

Indexed as

Black or African AmericanHispanic or LatinoWhite PeopleAdultAgedDelayed Graft FunctionFemaleHealth Care CostsHealth Status DisparitiesHumansIntensive Care UnitsKidney TransplantationLength of StayMaleMiddle AgedMortalityKASKidney transplantPeri-operative outcomesRacial disparities

Identifiers

PMID29557046
PMCPMC6190482

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.