Disparities in cystic fibrosis survival in Mexico: Impact of
socioeconomical status
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.