Impact of family socio-economic status on the prognosis of heart transplantation in children
Abstract Background Low family socio-economic status is a known factor that can contribute to increased mortality for patients with cardiovascular disease. However, in developing countries, the prognostic impact of socio-economic level on pediatric HTx is unclear. Methods We conducted a retrospectiv...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12889-025-21363-w |
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| author | Shun Liu Han Mo Yiqi Zhao Xiao Chen Weiteng Wang Yijing Li Ningning Zhang Mengni Bao Zeyu Cui Qian Zhao Jun Yan Xiumeng Hua Jiangping Song |
| author_facet | Shun Liu Han Mo Yiqi Zhao Xiao Chen Weiteng Wang Yijing Li Ningning Zhang Mengni Bao Zeyu Cui Qian Zhao Jun Yan Xiumeng Hua Jiangping Song |
| author_sort | Shun Liu |
| collection | DOAJ |
| description | Abstract Background Low family socio-economic status is a known factor that can contribute to increased mortality for patients with cardiovascular disease. However, in developing countries, the prognostic impact of socio-economic level on pediatric HTx is unclear. Methods We conducted a retrospective cohort analysis of children younger than 18 years who underwent heart transplantation (HTx) at our center from October 1, 2005, to May 31, 2023. To assess the impact of socio-economic status, we followed up with the discharged children until September 30, 2023, monitoring for all-cause mortality and unplanned readmission events. To evaluate the relationship between socio-economic status and prognosis, we assigned a composite score based on an assessment of household income, parental education level, and occupation. The Cox proportional hazards model and the Kaplan-Meier method were utilized for this analysis. Results 64 children (median age at operation 14 years, IQR 13–15) were enrolled and one case died in hospital due to primary graft dysfunction, 63 (98.4%) children had a median follow-up of 60 months (IQR 5.9-113.9). During the follow-up period, 10 (15.9%) children died, and 20 (31.7%) children had 25 unplanned readmissions. Children had higher all-cause mortality and more unplanned readmissions in families with low socio-economic status (n = 33) than middle (n = 10) or high (n = 20) family socio-economic status. Hazard ratios were 5.99,(95%CI:2.28–10.64, P = 0.003) for all-cause mortality for low versus high family socio-economic status, and 2.53 (95%CI:1.04–9.43, P = 0.029) for middle versus high family socio-economic status. Conclusions Lower family socio-economic status is associated with a worse prognosis than high family socio-economic status. Measures to alleviate economic disparities are needed to improve the prognosis of pediatric HTx. |
| format | Article |
| id | doaj-art-64e0464fa6f247fbaba94bf4da3786a2 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-64e0464fa6f247fbaba94bf4da3786a22025-02-02T12:46:25ZengBMCBMC Public Health1471-24582025-01-0125111110.1186/s12889-025-21363-wImpact of family socio-economic status on the prognosis of heart transplantation in childrenShun Liu0Han Mo1Yiqi Zhao2Xiao Chen3Weiteng Wang4Yijing Li5Ningning Zhang6Mengni Bao7Zeyu Cui8Qian Zhao9Jun Yan10Xiumeng Hua11Jiangping Song12Department of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeShenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical SciencesDepartment of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing Key Laboratory of Preclinical Research and Evaluation for Cardiovascular Implant Materials, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeShenzhen Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical SciencesState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Cardiac Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background Low family socio-economic status is a known factor that can contribute to increased mortality for patients with cardiovascular disease. However, in developing countries, the prognostic impact of socio-economic level on pediatric HTx is unclear. Methods We conducted a retrospective cohort analysis of children younger than 18 years who underwent heart transplantation (HTx) at our center from October 1, 2005, to May 31, 2023. To assess the impact of socio-economic status, we followed up with the discharged children until September 30, 2023, monitoring for all-cause mortality and unplanned readmission events. To evaluate the relationship between socio-economic status and prognosis, we assigned a composite score based on an assessment of household income, parental education level, and occupation. The Cox proportional hazards model and the Kaplan-Meier method were utilized for this analysis. Results 64 children (median age at operation 14 years, IQR 13–15) were enrolled and one case died in hospital due to primary graft dysfunction, 63 (98.4%) children had a median follow-up of 60 months (IQR 5.9-113.9). During the follow-up period, 10 (15.9%) children died, and 20 (31.7%) children had 25 unplanned readmissions. Children had higher all-cause mortality and more unplanned readmissions in families with low socio-economic status (n = 33) than middle (n = 10) or high (n = 20) family socio-economic status. Hazard ratios were 5.99,(95%CI:2.28–10.64, P = 0.003) for all-cause mortality for low versus high family socio-economic status, and 2.53 (95%CI:1.04–9.43, P = 0.029) for middle versus high family socio-economic status. Conclusions Lower family socio-economic status is associated with a worse prognosis than high family socio-economic status. Measures to alleviate economic disparities are needed to improve the prognosis of pediatric HTx.https://doi.org/10.1186/s12889-025-21363-wHeart transplantationChildrenSocio-economic statusPrognosis |
| spellingShingle | Shun Liu Han Mo Yiqi Zhao Xiao Chen Weiteng Wang Yijing Li Ningning Zhang Mengni Bao Zeyu Cui Qian Zhao Jun Yan Xiumeng Hua Jiangping Song Impact of family socio-economic status on the prognosis of heart transplantation in children BMC Public Health Heart transplantation Children Socio-economic status Prognosis |
| title | Impact of family socio-economic status on the prognosis of heart transplantation in children |
| title_full | Impact of family socio-economic status on the prognosis of heart transplantation in children |
| title_fullStr | Impact of family socio-economic status on the prognosis of heart transplantation in children |
| title_full_unstemmed | Impact of family socio-economic status on the prognosis of heart transplantation in children |
| title_short | Impact of family socio-economic status on the prognosis of heart transplantation in children |
| title_sort | impact of family socio economic status on the prognosis of heart transplantation in children |
| topic | Heart transplantation Children Socio-economic status Prognosis |
| url | https://doi.org/10.1186/s12889-025-21363-w |
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