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Disparities in cystic fibrosis survival in Mexico: Impact of socioeconomical status
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  • Adriana Bustamante,
  • Lucia Fernandez,
  • Lissette Rivas,
  • Roberto Mercado Longoria
Adriana Bustamante
Hospital Universitario Dr Jose Eleuterio Gonzalez
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Lucia Fernandez
Hospital Universitario Dr Jose Eleuterio Gonzalez
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Lissette Rivas
Hospital Universitario Dr Jose Eleuterio Gonzalez
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Roberto Mercado Longoria
Hospital Universitario Dr Jose Eleuterio Gonzalez
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Abstract

Background. Median survival age in cystic fibrosis (CF) has increased in developed countries. Scarce literature exists about survival in Latin American, especially in Mexico. The aim of our study was to assess the median age of CF patients’ survival in Mexico over a 20-year period. Methods. We conducted a retrospective study, with all patients registered and followed in the CF Center in Monterrey, Mexico from 2000 to 2020. Median survival age was the primary outcome, assessed with the Kaplan-Meier analysis. Influence of clinical, biological, and demographic factors on survival were analyzed with the Cox regression model. Results. Two-hundred five patients were included. Median survival for the cohort was 21.37 years (95% CI 17.20 – 25.55). In the multivariate Cox regression model, low socioeconomic status (hazard ratio [HR] 4.21, 95% CI 2.43 – 7.27), chronic Pseudomonas aeruginosa (P. aeruginosa) infection at 6 years (HR 10.45, 95% CI 5.66 – 19.28), and pancreatic insufficiency (HR 3.13, 1.38 – 7.13) were independent risk factors for mortality. Conclusion. Median survival in Mexican patients with CF is lower than in high-income countries, and socioeconomic status plays a conspicuous role in the disparity. To increase patient survival for those residing in low-income countries, public health authorities must design policies that fully cover diagnosis and treatment strategies for the CF population.

Peer review status:Published

14 Nov 2020Submitted to Pediatric Pulmonology
17 Nov 2020Submission Checks Completed
17 Nov 2020Assigned to Editor
21 Nov 2020Reviewer(s) Assigned
30 Dec 2020Review(s) Completed, Editorial Evaluation Pending
31 Dec 2020Editorial Decision: Revise Minor
10 Jan 20211st Revision Received
11 Jan 2021Submission Checks Completed
11 Jan 2021Assigned to Editor
11 Jan 2021Reviewer(s) Assigned
25 Feb 2021Review(s) Completed, Editorial Evaluation Pending
27 Feb 2021Editorial Decision: Accept
03 Mar 2021Published in Pediatric Pulmonology. 10.1002/ppul.25351