1
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Magarinos J, Egelko A, Criner GJ, Abbas A, Enofe N, Thomas J, Carney K, Friedberg J, Bakhos C. Lung volume reduction surgery is safe and leads to functional improvement in patients who fail or cannot undergo bronchoscopic lung volume reduction. JTCVS Open 2024; 18:369-375. [PMID: 38690414 PMCID: PMC11056479 DOI: 10.1016/j.xjon.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 01/30/2024] [Accepted: 02/02/2024] [Indexed: 05/02/2024]
Abstract
Background Bronchoscopic lung volume reduction (BLVR) has supplanted surgery in the treatment of patients with advanced emphysema, but not all patients qualify for it. Our study aimed to investigate the outcomes of lung volume reduction surgery (LVRS) among patients who either failed BLVR or were not candidates for it. Methods We conducted a retrospective analysis of patients who underwent LVRS for upper lobe-predominant emphysema at a single tertiary center between March 2018 and December 2022. The main outcomes measures were preoperative and postoperative respiratory parameters, perioperative morbidity, and mortality. Results A total of 67 LVRS recipients were evaluated, including 10 who had failed prior valve placement. The median patient age was 69 years, and 35 (52%) were male. All procedures were performed thoracoscopically, with 36 patients (53.7%) undergoing bilateral LVRS. The median hospital length of stay was 7 days (interquartile range, 6-11 days). Prolonged air leak (>7 days) occurred in 20 patients. There was one 90-day mortality from a nosocomial pneumonia (non-COVID-related) and no further deaths at 12 months. There were mean improvements of 10.07% in forced expiratory volume in 1 second and 4.74% in diffusing capacity of the lung for carbon monoxide, along with a mean decrease 49.2% in residual volume (P < .001 for all). The modified Medical Research Council dyspnea scale was improved by 1.84 points (P < .001). Conclusions LVRS can be performed safely in patients who are not candidates for BLVR and those who fail BLVR and leads to significant functional improvement. Long-term follow-up is necessary to ensure the sustainability of LVRS benefits in this patient population.
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Affiliation(s)
- Jessica Magarinos
- Department of General Surgery, Temple University Hospital, Philadelphia, Pa
| | - Aron Egelko
- Department of General Surgery, Temple University Hospital, Philadelphia, Pa
| | - Gerard J. Criner
- Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, Pa
| | - Abbas Abbas
- Lifespan Health System, Department of Thoracic Oncology, Brown University, Providence, RI
| | - Nosayaba Enofe
- Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, Pa
| | - JiJi Thomas
- Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, Pa
| | - Kevin Carney
- Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, Pa
| | - Joseph Friedberg
- Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, Pa
| | - Charles Bakhos
- Department of Thoracic Medicine and Surgery, Temple University Hospital, Philadelphia, Pa
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2
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Enofe N, Garcia Russo M, Kadakia ER, Axelrod PI, Friedberg J, Su S, Kumar R. Mediastinal Mass, Cancer, or Infection, Atypical Paraesophageal Actinomycosis Infection, Clinical and Surgical Approach. Am Surg 2024; 90:468-470. [PMID: 38009532 DOI: 10.1177/00031348231211039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Actinomyces israelii (AI) is a Gram-positive, rod-shaped bacterium that lives commensally on and within humans as a typical colonizer within the gastrointestinal tract, including the mouth. As an opportunistic pathogen, infection often results from tissue injury or breach of the mucosal barrier (ie, during various dental or GI procedures, aspiration, or specific pathologies such as diverticulitis). Symptoms generally present slowly as a non-tender, indurated mass that evolves into multiple abscesses, fistulae, or draining sinus tracts without regard for anatomical barriers, including fascial planes or lymphatic drainage. However, it may also present as an acute suppurative infection with pain and rapid progression to abscess formation.
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Affiliation(s)
- Nosayaba Enofe
- Division of Thoracic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
- Division of Thoracic Surgery, Temple University Hospital, Philadelphia, PA, USA
| | - Manuel Garcia Russo
- Department of Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Esha R Kadakia
- Department of Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Peter I Axelrod
- Division of Infectious Diseases, Department of Medicine, Temple University Hospital, Philadelphia, PA, USA
| | - Joseph Friedberg
- Division of Thoracic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
- Division of Thoracic Surgery, Temple University Hospital, Philadelphia, PA, USA
- Department of Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Stacey Su
- Division of Thoracic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Rohit Kumar
- Division of Thoracic Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
- Division of Pulmonology, Fox Chase Cancer Center, Philadelphia, PA, USA
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3
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Hutchings H, Behinaein P, Enofe N, Brue K, Tam S, Chang S, Movsas B, Poisson L, Wang A, Okereke I. Association of Social Determinants with Patient-Reported Outcomes in Patients with Cancer. Cancers (Basel) 2024; 16:1015. [PMID: 38473374 DOI: 10.3390/cancers16051015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
Patient-reported outcome (PRO) scores have been utilized more frequently, but the relationship of PRO scores to determinants of health and social inequities has not been widely studied. Our goal was to determine the association of PRO scores with social determinants. All patients with a new cancer diagnosis who completed a PRO survey from 2020 to 2022 were included. The PRO survey recorded scores for depression, fatigue, pain interference and physical function. Higher depression, fatigue and pain scores indicated more distress. Higher physical condition scores indicated improved functionality. A total of 1090 patients were included. Married patients had significantly better individual PRO scores for each domain. Patients who were able to use the online portal to complete their survey also had better individual scores. Male patients and non-White patients had worse pain scores than female and White patients, respectively. Patients with prostate cancer had the best scores while patients with head and neck and lung cancer had the worst scores. PRO scores varied by cancer disease site and stage. Social support may act in combination with specific patient/tumor factors to influence PRO scores. These findings present opportunities to address patient support at institutional levels.
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Affiliation(s)
- Hollis Hutchings
- Department of Surgery, Henry Ford Health, Detroit, MI 48202, USA
| | - Parnia Behinaein
- School of Medicine, Wayne State University, Detroit, MI 48202, USA
| | - Nosayaba Enofe
- Division of Surgical Oncology, Department of Thoracic Surgery, Fox Chase Cancer Center, Temple University Hospital, Philadelphia, PA 19140, USA
| | - Kellie Brue
- School of Medicine, Wayne State University, Detroit, MI 48202, USA
| | - Samantha Tam
- Department of Otolaryngology, Henry Ford Health, Detroit, MI 48202, USA
| | - Steven Chang
- Department of Otolaryngology, Henry Ford Health, Detroit, MI 48202, USA
| | - Benjamin Movsas
- Department of Radiation Oncology, Henry Ford Cancer Institute, Detroit, MI 48202, USA
| | - Laila Poisson
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI 48202, USA
| | - Anqi Wang
- Department of Public Health Sciences, Henry Ford Health, Detroit, MI 48202, USA
| | - Ikenna Okereke
- Department of Surgery, Henry Ford Health, Detroit, MI 48202, USA
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4
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Meyer CH, Grant AA, Enofe N, Matey A, Frankinburger E, Sola R, Nguyen J, Andrade IFP, Veselsky SL, Sciarretta J, Williams KN, Kim S, Smith RN. Organ donation after self-inflicted injury: A single institution analysis. Clin Transplant 2022; 36:e14679. [PMID: 35533053 DOI: 10.1111/ctr.14679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 04/06/2022] [Accepted: 04/12/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study sought to determine the contribution of self-inflicted injury-related deaths to local organ donation rates and analyze contributing factors. METHODS A retrospective review of adult patients with traumatic self-inflicted injuries was performed at a Level I trauma center from 2013 to 2017. Data were obtained from the institutional trauma registry and cross-referenced with the local organ procurement organization (OPO). Referral rates were analyzed and outcomes, demographics and injury characteristics were compared between patients who underwent donation versus those who did not. RESULTS 142 adult patients presented with traumatic self-inflicted injury, and 100 (70.4%) had referral calls made to the local OPO. These patients were predominantly male (83%), and gunshot injuries accounted for 75% of all mechanisms. Sixty-four percent had organ referrals versus tissue referrals (34%), and 17 (26.6%) of those patients went on to donate. The median number of organs procured was 4 [IQR 0-5]. In multivariate analysis, for each year increase in age, patients were less likely to have an organ referral (OR = .96 [95% CI .93-.99]; p = .0134) and less likely to undergo donation (OR = .95 [95% CI .90-.99]; p = .0308). CONCLUSIONS Self-inflicted injury, though tragic, may provide a significant contribution to the limited organ donor registry.
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Affiliation(s)
- Courtney H Meyer
- Emory University School of Medicine, Atlanta, Georgia, USA.,Grady Health System, Atlanta, Georgia, USA.,Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - April A Grant
- Emory University School of Medicine, Atlanta, Georgia, USA.,Grady Health System, Atlanta, Georgia, USA
| | - Nosayaba Enofe
- Emory University School of Medicine, Atlanta, Georgia, USA.,Grady Health System, Atlanta, Georgia, USA
| | | | - Emil Frankinburger
- Grady Health System, Atlanta, Georgia, USA.,Lifelink Foundation, Atlanta, Georgia, USA
| | - Richard Sola
- Grady Health System, Atlanta, Georgia, USA.,Morehouse School of Medicine, Atlanta, Georgia, USA
| | - Jonathan Nguyen
- Grady Health System, Atlanta, Georgia, USA.,Morehouse School of Medicine, Atlanta, Georgia, USA
| | | | - Steven L Veselsky
- Emory University School of Medicine, Atlanta, Georgia, USA.,Grady Health System, Atlanta, Georgia, USA.,West Virginia School of Osteopathic Medicine, Lewisburg, West Virginia, USA
| | - Jason Sciarretta
- Emory University School of Medicine, Atlanta, Georgia, USA.,Grady Health System, Atlanta, Georgia, USA
| | - Keneeshia N Williams
- Emory University School of Medicine, Atlanta, Georgia, USA.,Grady Health System, Atlanta, Georgia, USA
| | - Steven Kim
- Emory University School of Medicine, Atlanta, Georgia, USA.,University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Randi N Smith
- Emory University School of Medicine, Atlanta, Georgia, USA.,Grady Health System, Atlanta, Georgia, USA.,Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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5
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Enofe N, Morris AD, Liu Y, Liang W, Wu CS, Sullivan PS, Balch GG, Staley CA, Gillespie TW, Shaffer VO. Receipt of Adjuvant Chemotherapy in Stage II Colon Cancer and Overall Survival: A National Cancer Database Study. J Surg Res 2020; 252:69-79. [PMID: 32244127 DOI: 10.1016/j.jss.2020.02.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 01/07/2020] [Accepted: 02/16/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND There are variations in the use of adjuvant chemotherapy (AC) in stage II colon cancer (CRC). We sought to determine which patients received chemotherapy, what factors were associated with receipt of AC, and how this impacted overall survival. METHODS Using the National Cancer Database, patients with stage II CRC who underwent surgical resection were selected; patients who received radiation or neoadjuvant chemotherapy were excluded. High-risk features (HRFs) were defined as pathological tumor stage IV, positive surgical margins, and perineural or lymphovascular invasion. Multivariable and subgroup analysis with eight subgroups stratified in the presence of HRFs, age, and the Charlson-Deyo score was performed. RESULTS Of 77,739 patients identified with stage II CRC, 18.3% received AC. Younger, healthier patients with HRFs had the highest chemotherapy receipt rate (46.7%), whereas patients without HRFs, ≥ 75 y, and with the Charlson-Deyo score of 2+ had the lowest rate (2.1%). Community cancer centers were more likely to initiate AC (odds ratio = 1.24 P < 0.01) especially among healthy HRF-negative patients and younger patients. No significant racial differences in AC use were observed. AC was associated with improved overall survival in subgroups with HRFs (hazard ratio [HR]: 0.81 P < 0.001; HR: 0.75 P < 0.001; HR: 0.65 P = 0.03; HR: 0.55, P < 0.001) but not in patients without HRFs. CONCLUSIONS AC receipt rates differed depending on patient age and type of institution delivering care. AC was associated with survival benefits only in patients with HRFs regardless of age. These findings are clinically relevant to inform appropriate use of AC in stage II CRC.
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Affiliation(s)
- Nosayaba Enofe
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Andrew D Morris
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Yuan Liu
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Wendi Liang
- Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Christina S Wu
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia
| | - Patrick S Sullivan
- Division of Colorectal Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Glen G Balch
- Division of Colorectal Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Charles A Staley
- Division of Colorectal Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Theresa W Gillespie
- Department of Surgery Winship Cancer Institute at Emory University, Emory University School of Medicine, Atlanta, Georgia
| | - Virginia O Shaffer
- Division of Colorectal Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
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6
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Enofe N, Howard DH, Kumarusamy MA, Sullivan PS, Srinivasan JK, Staley CA, Esper GJ, Sweeney JF, Sharma J, Shaffer VO. Decreasing Hospital Readmission in Ileostomy Patients: A Follow-Up Study of a Novel Pilot Program. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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7
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Ilori TO, Enofe N, Oommen A, Cobb J, Navarrete J, Adedinsewo DA, Oshikoya O, Fevrier H, Farris AB, Plantinga L, Ojo AO. Comparison of Outcomes between Individuals with Pure and Mixed Lupus Nephritis: A Retrospective Study. PLoS One 2016; 11:e0157485. [PMID: 27304068 PMCID: PMC4909281 DOI: 10.1371/journal.pone.0157485] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 05/30/2016] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Lupus nephritis (LN) is a serious organ manifestation of systemic lupus erythematosus. Histologic overlap is relatively common in the six pathologic classes (I to VI) of LN. For example, mixed proliferative LN (MPLN) often includes features of classes III & V or classes IV & V combined. We performed a comparative evaluation of renal outcomes in patients with MPLN to patients with pure proliferative LN (PPLN) against pre-specified renal outcomes, and we also identified predictor of clinical outcomes among those with PPLN and MPLN. HYPOTHESIS Individuals with MPLN will have worse short-term renal outcomes compared to those with PPLN. METHODS We retrospectively reviewed 278 adult LN patients (≥18 years old) identified from an Emory University Hospital registry of native renal biopsies performed between January 2000 and December 2011. The final analytic sample consisted of individuals with a diagnosis of PPLN (n = 60) and MPLN (n = 96). We analyzed differences in clinical and laboratory characteristics at baseline. We also assessed associations between LN category and renal outcomes (complete remission and time to ESRD) with logistic and Cox proportional hazards models within two years of baseline. RESULTS The study population was predominantly female (83.97%) and African American (71.8%) with a mean age of 33.4 years at baseline. Over a median follow up of 1.02 years, we did not find any statistically significant associations between MPLN and the development of ESRD or remission when compared to patients with PPLN (adjusted HR = 0.30, 95% CI = 0.07, 1.26). CONCLUSION There was no association between mixed or pure histopathologic features of LN at presentation and rate of complete or partial remission but higher baseline eGFR was associated with a lower probability of complete remission among patients with lupus nephritis.
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Affiliation(s)
- Titilayo O. Ilori
- Division of Nephrology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
- * E-mail:
| | - Nosayaba Enofe
- Division of Nephrology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Anju Oommen
- Division of Nephrology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Jason Cobb
- Division of Nephrology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Jose Navarrete
- Division of Nephrology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Demilade A. Adedinsewo
- Department of Medicine, Morehouse School of Medicine, Atlanta, Georgia, United States of America
| | - Oluwatobiloba Oshikoya
- Institute for Cardiovascular and Metabolic Disease, University of North Texas Health Science Center, Fort Worth, Texas, United States of America
| | - Helene Fevrier
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Alton B. Farris
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - Laura Plantinga
- Division of Nephrology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Emory Transplant Center, Department of Surgery, Emory University, Atlanta, Georgia, United States of America
| | - Akinlolu O. Ojo
- Division of Nephrology, University of Michigan, Ann Arbor, Michigan, United States of America
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8
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Ilori TO, Adedinsewo DA, Odewole O, Enofe N, Ojo AO, McClellan W, Patzer RE. Racial and Ethnic Disparities in Graft and Recipient Survival in Elderly Kidney Transplant Recipients. J Am Geriatr Soc 2015; 63:2485-2493. [PMID: 26660200 DOI: 10.1111/jgs.13845] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To investigate racial and ethnic differences in graft and recipient survival in elderly kidney transplant recipients. DESIGN Retrospective cohort. SETTING First-time, kidney-only transplant recipients aged 60 and older of age at transplantation transplanted between July 1996 and October 2010 (N = 44,013). PARTICIPANTS United Network for Organ Sharing (UNOS) database. MEASUREMENTS Time to graft failure and death obtained from the UNOS database and linkage to the Social Security Death Index. Neighborhood poverty from 2000 U.S. Census geographic data. RESULTS Of the 44,013 recipients in the sample, 20% were black, 63% non-Hispanic white, 11% Hispanic, 5% Asian, and the rest "other racial groups." In adjusted Cox models, blacks were more likely than whites to experience graft failure (hazard ratio (HR) = 1.23, 95% confidence interval (CI) = 1.15-1.32), whereas Hispanics (HR = 0.77, 95% CI = 0.70-0.85) and Asians (HR = 0.70, 95% CI = 0.61-0.81) were less likely to experience graft failure. Blacks (HR = 0.84, 95% CI = 0.80-0.88), Hispanics (HR = 0.68, 95% CI = 0.64-0.72), and Asians (HR = 0.62, 95% CI = 0.57-0.68) were less likely than whites to die after renal transplantation. CONCLUSION Elderly blacks are at greater risk of graft failure than white transplant recipients but survive longer after transplantation. Asians have the highest recipient and graft survival, followed by Hispanics. Further studies are needed to assess additional factors affecting graft and recipient survival in elderly adults and to investigate outcomes such as quality of life.
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Affiliation(s)
| | | | | | - Nosayaba Enofe
- Department of Medicine, Emory University, Atlanta, Georgia
| | - Akinlolu O Ojo
- Department of Medicine, University of Michigan, Ann Arbor, Michigan
| | - William McClellan
- Department of Medicine, Emory University, Atlanta, Georgia.,Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Rachel E Patzer
- Rollins School of Public Health, Emory University, Atlanta, Georgia.,Department of Surgery, School of Medicine, Emory University, Atlanta, Georgia
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9
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Ilori TO, Enofe N, Oommen A, Odewole O, Ojo A, Plantinga L, Pastan S, Echouffo-Tcheugui JB, McClellan W. Factors affecting willingness to receive a kidney transplant among minority patients at an urban safety-net hospital: a cross-sectional survey. BMC Nephrol 2015; 16:191. [PMID: 26588895 PMCID: PMC4654893 DOI: 10.1186/s12882-015-0186-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 11/09/2015] [Indexed: 11/21/2022] Open
Abstract
Background In the US, African Americans (AAs) are four times more likely to develop end stage renal disease (ESRD) but half as likely to receive a kidney transplant as whites. Patient interest in kidney transplantation is a fundamental step in the kidney transplant referral process. Our aim was to determine the factors associated with the willingness to receive a kidney transplant among chronic kidney disease (CKD) patients in a predominantly minority population. Methods CKD patients from an outpatient nephrology clinic at a safety-net hospital (n = 213) participated in a cross-sectional survey from April to June, 2013 to examine the factors associated with willingness to receive a kidney transplant among a predominantly minority population. The study questionnaire was developed from previously published literature. Multivariable logistic regression analysis was used to determine factors associated with willingness to undergo a kidney transplant. Results Respondents were primarily AAs (91.0 %), mostly female (57.6 %) and middle aged (51.6 %). Overall, 53.9 % of participants were willing to undergo a kidney transplant. Willingness to undergo a kidney transplant was associated with a positive perception towards living kidney donation (OR 7.31, 95 % CI: 1.31–40.88), willingness to attend a class about kidney transplant (OR = 7.15, CI: 1.76–29.05), perception that a kidney transplant will improve quality of life compared to dialysis (OR = 5.40, 95 % CI: 1.97–14.81), and obtaining information on kidney transplant from other sources vs. participant’s physician (OR =3.30, 95 % CI: 1.13–9.67), when compared with their reference groups. Conclusion It is essential that the quality of life benefits of kidney transplantation be known to individuals with CKD to increase their willingness to undergo kidney transplantation. Availability of multiple sources of information and classes on kidney transplantation may also contribute to willingness to undergo kidney transplantation, especially among AAs. Electronic supplementary material The online version of this article (doi:10.1186/s12882-015-0186-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Titilayo O Ilori
- Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA. .,Renal Division, Emory University School of Medicine, 1639 Pierce Drive, Atlanta GA. Clifton Road, Atlanta, Georgia, 30322, USA.
| | - Nosayaba Enofe
- Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA.
| | - Anju Oommen
- Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA.
| | - Oluwaseun Odewole
- Department of Radiology and Imaging Science, Emory University School of Medicine, Atlanta, Georgia, USA.
| | - Akinlolu Ojo
- Department of Medicine, Renal Division, University of Michigan, Ann Arbor, Michigan, USA.
| | - Laura Plantinga
- Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA.
| | - Stephen Pastan
- Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA. .,Emory Transplant Center, Emory Healthcare, Atlanta, Georgia, USA.
| | - Justin B Echouffo-Tcheugui
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA. .,MedStar Health, Baltimore, Maryland, USA.
| | - William McClellan
- Department of Medicine, Renal Division, Emory University School of Medicine, Atlanta, Georgia, USA. .,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.
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10
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Abstract
OBJECTIVE To examines smoking status, substance use, sociodemographics, and psychosocial characteristics in relation to alternative tobacco use among college students. METHODS Current tobacco use (cigarettes, cigar-like products, hookah, chew, snus) and correlates (sociodemographics, sensation-seeking, attitudes toward tobacco and smokers, social factors) were assessed among students aged 18-25 at 6 Southeastern US colleges using an online survey. RESULTS Those who were younger, male, black, cigarette and marijuana users, and demonstrating at-risk psychosocial factors were at increased risk of alternative tobacco product use (p < .001). Among current smokers, never daily nondaily smokers were 3 times as likely as former daily non-daily smokers and daily smokers to use alternative tobacco products (p < .001). CONCLUSIONS Important risk factors for alternative tobacco use included important sociodemographic and psychosocial characteristics.
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Affiliation(s)
- Nosayaba Enofe
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA.
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA
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