现在的位置: 首页研究点评, 进展交流>正文
[ICU Management & Practice]: 有关ECMO的健康差异
2023年10月20日 研究点评, 进展交流 [ICU Management & Practice]: 有关ECMO的健康差异已关闭评论

Health Disparities in ECMO

A recent review explored the extent and quality of literature investigating the influence of social determinants of health (SDoH) on extracorporeal membrane oxygenation (ECMO) utilisation and outcomes among children and adults. The researchers examined the relationship between factors like socioeconomic status, education, and access to healthcare with the use and effectiveness of ECMO.

A total of 219 publications were identified. The primary focus of the analysis was on 148 studies that examined variables related to race, ethnicity, socioeconomic status (SES), and payer. One hundred fourteen studies investigated ECMO outcomes, and 43 studies explored ECMO utilisation.

SDoH were the primary predictor in only 15 studies. The overall quality and methodological rigour of the included studies were found to be poor, with only 7% employing advanced statistical methods.

The direction of associations between ECMO outcomes or utilisation and race, ethnicity, SES, or payer varied across studies. 38% of the studies reported adverse outcomes or lower utilisation in underrepresented, under-resourced, or diverse populations, while 7% observed improved outcomes or greater utilisation in these populations. The remaining 55% of studies did not find statistically significant results. Only 26 studies discussed the underlying causes of disparities, primarily focusing on individual- and hospital-level factors rather than systemic or structural factors.

The review also identified several shortcomings in the existing studies. These included poor quality and methodological rigour, inadequate scientific contextualisation of the findings, and insufficient consideration of systemic mediators that could influence the relationship between SDoH and ECMO utilisation or outcomes.

Overall, the findings suggest a limited understanding of the associations between social determinants of health and ECMO utilisation or outcomes. The studies included in the study had methodological limitations, and the direction of the associations varied, highlighting the need for further research in this area. Additionally, there is a need to explore systemic and structural factors that contribute to disparities in ECMO utilisation and outcomes. Such efforts will lead to better measurement and interpretation of SDoH in ECMO research and inform healthcare practices.

Source: Critical Care Medicine

Image Credit: iStock

«« Human-Centred Visualisation Technologies for Patient Monitoring

Real Time Early Warning System Using Machine Learning »»

References:

Moynihan KM, Dorste A, Alizadeh F et al. (2023) Health Disparities in Extracorporeal Membrane Oxygenation Utilization and Outcomes: A Scoping Review and Methodologic Critique of the Literature. Crit Care Med. 51(7):843-860.

Published on : Wed, 28 Jun 2023

抱歉!评论已关闭.

×
腾讯微博