Association of the social disorganization index with time to first septic shock event in children with acute myeloid leukemia
© 2023 American Cancer Society..
BACKGROUND: Pediatric acute myeloid leukemia (AML) chemotherapy increases the risk of life-threatening complications, including septic shock (SS). An area-based measure of social determinants of health, the social disorganization index (SDI), was hypothesized to be associated with SS and SS-associated death (SS-death).
METHODS: Children treated for de novo AML on two Children's Oncology Group trials at institutions contributing to the Pediatric Health Information System (PHIS) database were included. The SDI was calculated via residential zip code data from the US Census Bureau. SS was identified via PHIS resource utilization codes. SS-death was defined as death within 2 weeks of an antecedent SS event. Patients were followed from 7 days after the start of chemotherapy until the first of end of front-line therapy, death, relapse, or removal from study. Multivariable-adjusted Cox regressions estimated hazard ratios (HRs) comparing time to first SS by SDI group.
RESULTS: The assembled cohort included 700 patients, with 207 (29.6%) sustaining at least one SS event. There were 233 (33%) in the SDI-5 group (highest disorganization). Adjusted time to incident SS did not statistically significantly differ by SDI (reference, SDI-1; SDI-2: HR, 0.84 [95% confidence interval (CI), 0.51-1.41]; SDI-3: HR, 0.70 [95% CI, 0.42-1.16]; SDI-4: HR, 0.97 [95% CI, 0.61-1.53]; SDI-5: HR, 0.72 [95% CI, 0.45-1.14]). Nine patients (4.4%) with SS experienced SS-death; seven of these patients (78%) were in SDI-4 or SDI-5.
CONCLUSIONS: In a large, nationally representative cohort of trial-enrolled pediatric patients with AML, there was no significant association between the SDI and time to SS.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:130 |
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| Enthalten in: |
Cancer - 130(2024), 6 vom: 15. März, Seite 962-972 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ruiz, Jenny [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 26.02.2024 Date Revised 03.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/cncr.35109 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364767804 |
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| 245 | 1 | 0 | |a Association of the social disorganization index with time to first septic shock event in children with acute myeloid leukemia |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 26.02.2024 | ||
| 500 | |a Date Revised 03.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 American Cancer Society. | ||
| 520 | |a BACKGROUND: Pediatric acute myeloid leukemia (AML) chemotherapy increases the risk of life-threatening complications, including septic shock (SS). An area-based measure of social determinants of health, the social disorganization index (SDI), was hypothesized to be associated with SS and SS-associated death (SS-death) | ||
| 520 | |a METHODS: Children treated for de novo AML on two Children's Oncology Group trials at institutions contributing to the Pediatric Health Information System (PHIS) database were included. The SDI was calculated via residential zip code data from the US Census Bureau. SS was identified via PHIS resource utilization codes. SS-death was defined as death within 2 weeks of an antecedent SS event. Patients were followed from 7 days after the start of chemotherapy until the first of end of front-line therapy, death, relapse, or removal from study. Multivariable-adjusted Cox regressions estimated hazard ratios (HRs) comparing time to first SS by SDI group | ||
| 520 | |a RESULTS: The assembled cohort included 700 patients, with 207 (29.6%) sustaining at least one SS event. There were 233 (33%) in the SDI-5 group (highest disorganization). Adjusted time to incident SS did not statistically significantly differ by SDI (reference, SDI-1; SDI-2: HR, 0.84 [95% confidence interval (CI), 0.51-1.41]; SDI-3: HR, 0.70 [95% CI, 0.42-1.16]; SDI-4: HR, 0.97 [95% CI, 0.61-1.53]; SDI-5: HR, 0.72 [95% CI, 0.45-1.14]). Nine patients (4.4%) with SS experienced SS-death; seven of these patients (78%) were in SDI-4 or SDI-5 | ||
| 520 | |a CONCLUSIONS: In a large, nationally representative cohort of trial-enrolled pediatric patients with AML, there was no significant association between the SDI and time to SS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Children’s Oncology Group (COG) | |
| 650 | 4 | |a pediatric acute myeloid leukemia (pediatric AML) | |
| 650 | 4 | |a septic shock | |
| 650 | 4 | |a social determinant of heath (SDOH) | |
| 650 | 4 | |a social disorganization index (SDI) | |
| 700 | 1 | |a Li, Yimei |e verfasserin |4 aut | |
| 700 | 1 | |a Cao, Lusha |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Yuan-Shung V |e verfasserin |4 aut | |
| 700 | 1 | |a Tam, Vicky |e verfasserin |4 aut | |
| 700 | 1 | |a Griffis, Heather M |e verfasserin |4 aut | |
| 700 | 1 | |a Winestone, Lena E |e verfasserin |4 aut | |
| 700 | 1 | |a Fisher, Brian T |e verfasserin |4 aut | |
| 700 | 1 | |a Alonzo, Todd A |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Yi-Cheng J |e verfasserin |4 aut | |
| 700 | 1 | |a Dang, Alice T |e verfasserin |4 aut | |
| 700 | 1 | |a Kolb, E Anders |e verfasserin |4 aut | |
| 700 | 1 | |a Glanz, Karen |e verfasserin |4 aut | |
| 700 | 1 | |a Getz, Kelly D |e verfasserin |4 aut | |
| 700 | 1 | |a Aplenc, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Seif, Alix E |e verfasserin |4 aut | |
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