Abstract
Purpose Heart transplant remains the therapy of choice in patients with end stage heart failure. However, the benefit of heart transplant is not uniform across all ethnicities. Studies done previously showed poor outcomes in Black patients if heart transplant was performed at less experienced centers. We aim to evaluate the racial and regional disparities in heart transplantation irrespective of performing center. Methods Patients who underwent heart transplantation between 2010 and 2017 were selected from the Healthcare Cost and Utilization Project National Inpatient Sample. Race was classified as Caucasians vs African Americans (AA) vs Hispanics and the outcomes were mortality, length of stay and hospital cost. One-way ANOVA test was used for statistical analysis. Results A total of 3137 patients who underwent heart transplantation were included in the analysis. Among this, 67% is Caucasians, 22.6% is AA and 10.3% is Hispanics. Caucasian heart transplant recipients were older, had higher rate of males and coronary artery disease. AA heart transplant recipients had higher rate of females and more frequently had median income in the lowest quartile but with lower rates of coronary artery disease. Hispanic heart transplant recipients were younger and with lower comorbidity index. Outcomes was adjusted for comorbidity index. In-hospital mortality following the heart transplant procedure was 5.3% in Caucasians compared to 6.6% in AA and 6.2% in Hispanics (p=0.28). Median length of stay was 23 days in Caucasians vs 25 days in AA vs 27 days in Hispanics (p=0.07). Median hospital billed cost in Caucasians was $563,438 compared to $584,221 in AA and $720,934 in Hispanics. (p Conclusion Regionally in-hospital mortality was significantly higher in Northeast and higher hospital costs in west region compared to other regions. Among various ethnic groups, there was no difference in mortality but there was significant difference in median hospital cost.
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