RESUMO
BACKGROUND: Socioeconomic status has been associated with inferior outcomes after multiple surgical procedures, but has not been well studied with respect to pediatric liver transplantation. This study evaluated the impact of insurance status (as a proxy for socioeconomic status) on patient and allograft survival in pediatric first-time liver transplant recipients. METHODS: Our retrospective analysis of the UNOS data base from January 2002 through September 2017 revealed 6997 pediatric patients undergoing first-time isolated liver transplantation. A mixed Cox proportional hazards model adjusted for donor, recipient, and program characteristics determined the RR of insurance status on allograft and patient survival. All results were considered significant at P < .05. All statistical results were obtained using R version 3.5.1 and coxme version 2.2-10. RESULTS: Medicaid status had a significant negative impact on long-term survival after controlling for multiple covariates. Pediatric patients undergoing first-time isolated liver transplantation with Medicaid insurance had a RR of 1.42 [confidence interval: 1.18-1.60] of post-transplant death. CONCLUSION: Pediatric patients undergoing first-time isolated liver transplantation have multiple risk factors that may impact long-term survival. Having Medicaid insurance almost doubles the chances of dying post-liver transplant. This patient population may require more global support post-transplant to improve long-term survival.
Assuntos
Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde/economia , Seguro Saúde , Transplante de Fígado/economia , Transplante de Fígado/mortalidade , Medicaid , Classe Social , Adolescente , Criança , Pré-Escolar , Feminino , Sobrevivência de Enxerto , Humanos , Lactente , Recém-Nascido , Masculino , Avaliação de Resultados em Cuidados de Saúde , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Estados Unidos/epidemiologiaRESUMO
We present new hairy black hole solutions of SU(N) Einstein-Yang-Mills (EYM) theory in asymptotically anti-de Sitter (AdS) space. These black holes are described by N+1 independent parameters and have N-1 independent gauge field degrees of freedom. Solutions in which all gauge field functions have no zeros exist for all N, and for a sufficiently large (and negative) cosmological constant. At least some of these solutions are shown to be stable under classical, linear, spherically symmetric perturbations. Therefore there is no upper bound on the amount of stable gauge field hair with which a black hole in AdS can be endowed.