Taking a Closer Look at Distance: Does Increasing the Maximal Donor Distance Range Shorten Waitlist Times in Pediatric Heart Transplant Candidates?

Abstract

Sample were identified. Hospitalizations were trended over years using Poisson regression and expressed as average annual percent change (AAPC), stratified by race. A yearly aggregate sum of HF-related procedures (valvular interventions, heart transplants, and left ventricular assist device implants) similarly trended by race. Results: Overall, 1,472,565 hospitalizations were identified. Total as well as primary cardiovascular hospitalizations significantly increased across all races (AAPC: White 8% and 7%, respectively; Black 9% and 9%, Hispanic 8% and 8%, other 7% and 8%). Rates of HF-related procedures were 145 per 1000 hospitalizations in White patients, 57 per 1000 in Black patients, 103 per 1000 in Hispanic patients, and 138 per 1000 in patients of other races. From 2000 to 2017, procedural rates increased in patients of all races: White (130 per 1000 to 163, p<0.0001), Black (51 per 1000 to 65, p<0.0001), Hispanic (75 per 1000 to 129, p<0.0001), and other races (71 per 1000 to 147, p<0.0001), (Figure). Similar trends were seen for each race when stratified by primary insurance. Conclusion: Rate of hospitalizations and HF-related procedures increased in patients with CHD from 2000 to 2017. Black and Hispanic patients had significantly fewer procedures compared to White patients regardless of insurance type. Further studies are needed to better ascertain the causes behind demographic disparities in procedural volumes in patients with CHD and to raise awareness among patients and providers.