Abstract: FR-PO0704
Effect of Social Determinants of Health (SDOH) on Outcomes in Shiga Toxin-Producing Escherichia coli Infection (STEC) and STEC-Hemolytic Uremic Syndrome (STEC-HUS)
Session Information
- Pediatric Nephrology: CKD, ESKD, and Glomerular Diseases
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pediatric Nephrology
- 1900 Pediatric Nephrology
Authors
- Corse, Tanner D, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Slaven, James, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Zhou, Laura Y, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Deitz, Ted, Indiana University Indianapolis, Indianapolis, Indiana, United States
- Laster, Marciana, Indiana University School of Medicine, Indianapolis, Indiana, United States
- Stone, Nicole, Indiana Department of Health, Indianapolis, Indiana, United States
- Khalid, Myda, Indiana University School of Medicine, Indianapolis, Indiana, United States
Background
Understanding the relationship between SDOH with STEC and STEC-HUS may identify areas for intervention to reduce disease severity and health care utilization. Area Deprivation Index (ADI) is a validated tool to measure neighborhood-level disadvantage.
Methods
An Indiana Department of Health database of 1,045 patients with laboratory-confirmed STEC from January 2019 to September 2023 was analyzed. Multivariable linear and logistic regressions were fit for associations with continuous and categorical outcomes, respectively. Backward selection was used to identify significantly associated covariates at p<0.10. Model interpretations were adjusted for selected covariates. Hot and Cold spots were identified using the Getis-Ord Gi statistic and Optimized Hot Spot Analysis tool in ArcGIS Pro.
Results
558 patients (53.4%) with STEC presented to an emergency department (ED). 338 patients (32.3%) were hospitalized. 35 patients (3.3%) progressed to STEC-HUS. 34 patients (97.1%) with STEC-HUS were hospitalized. 3 patients (0.3%) died.
Older age (slope (95% CI): 0.05 (0.01, 0.09); p=0.0171) and higher ADI (slope (95% CI): 0.06 (0.01, 0.11); p=0.0127) were associated with longer duration of illness. Younger age was associated with higher ED utilization (OR (95% CI): 1.01 (1.00, 1.02); p=0.0391) and higher risk of STEC-HUS (OR (95% CI): 1.04 (1.02, 1.06); p<.0001).
Conclusion
In the state of Indiana, younger individuals with STEC demonstrate higher rates of ED utilization and are at higher risk for progression to STEC-HUS. The relationship between ADI with STEC and STEC-HUS disease severity warrants further exploration.
Funding
- Private Foundation Support