{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T19:29:31Z","timestamp":1769455771593,"version":"3.49.0"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,11,20]],"date-time":"2023-11-20T00:00:00Z","timestamp":1700438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2024,3,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Pediatric acute myeloid leukemia (AML) chemotherapy increases the risk of life\u2010threatening complications, including septic shock (SS). An area\u2010based measure of social determinants of health, the social disorganization index (SDI), was hypothesized to be associated with SS and SS\u2010associated death (SS\u2010death).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children treated for de novo AML on two Children\u2019s Oncology Group trials at institutions contributing to the Pediatric Health Information System (PHIS) database were included. The SDI was calculated via residential zip code data from the US Census Bureau. SS was identified via PHIS resource utilization codes. SS\u2010death was defined as death within 2\u00a0weeks of an antecedent SS event. Patients were followed from 7\u00a0days after the start of chemotherapy until the first of end of front\u2010line therapy, death, relapse, or removal from study. Multivariable\u2010adjusted Cox regressions estimated hazard ratios (HRs) comparing time to first SS by SDI group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The assembled cohort included 700 patients, with 207 (29.6%) sustaining at least one SS event. There were 233 (33%) in the SDI\u20105 group (highest disorganization). Adjusted time to incident SS did not statistically significantly differ by SDI (reference,\u00a0SDI\u20101; SDI\u20102: HR, 0.84 [95% confidence interval (CI), 0.51\u20131.41]; SDI\u20103: HR, 0.70 [95% CI, 0.42\u20131.16]; SDI\u20104: HR, 0.97 [95% CI, 0.61\u20131.53]; SDI\u20105: HR, 0.72 [95% CI, 0.45\u20131.14]). Nine patients (4.4%) with SS experienced SS\u2010death; seven of these patients (78%) were in SDI\u20104 or SDI\u20105.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a large, nationally representative cohort of trial\u2010enrolled pediatric patients with AML, there was no significant association between the SDI and time to SS.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35109","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T17:44:20Z","timestamp":1700588660000},"page":"962-972","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association of the social disorganization index with time to first septic shock event in children with acute myeloid leukemia"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5319-3852","authenticated-orcid":false,"given":"Jenny","family":"Ruiz","sequence":"first","affiliation":[{"name":"Division of Oncology Children\u2019s Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yimei","family":"Li","sequence":"additional","affiliation":[{"name":"Division of Oncology Children\u2019s Hospital of Philadelphia  Philadelphia Pennsylvania USA"},{"name":"Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lusha","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Health Informatics Children\u2019s Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan\u2010Shung V.","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Health Informatics Children\u2019s Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicky","family":"Tam","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Health Informatics Children\u2019s Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather M.","family":"Griffis","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Health Informatics Children\u2019s Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9982-1594","authenticated-orcid":false,"given":"Lena E.","family":"Winestone","sequence":"additional","affiliation":[{"name":"Division of Allergy, Immunology, and Bone Marrow Transplantation Benioff Children\u2019s Hospital University of California San Francisco  San Francisco California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian T.","family":"Fisher","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"},{"name":"Division of Infectious Diseases Children\u2019s Hospital of Philadelphia  Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd A.","family":"Alonzo","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences Keck School of Medicine University of Southern California  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi\u2010Cheng J.","family":"Wang","sequence":"additional","affiliation":[{"name":"Public Health Institute  Monrovia California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alice T.","family":"Dang","sequence":"additional","affiliation":[{"name":"Public Health Institute  Monrovia California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. 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