Racial and Ethnic Differences in Wait-List Outcomes in Patients Listed for Heart Transplantation in the United States

Article

关键词: GLOMERULAR-FILTRATION-RATE;    SERUM CREATININE VALUES;    RENAL-DISEASE;    HEALTH-CARE;    DISPARITIES;    FAILURE;    MORTALITY;    SURVIVAL;    RACE;    INSURANCE;   

DOI  :  10.1161/CIRCULATIONAHA.112.092643

来源: SCIE

【 摘 要 】

Background-Racial differences in long-term survival after heart transplant (HT) are well known. We sought to assess racial/ethnic differences in wait-list outcomes among patients listed for HT in the United States in the current era. Methods and Results-We compared wait-list and posttransplant in-hospital mortality among white, black, and Hispanic patients >= 18 years of age listed for their primary HT in the United States between July 2006 and September 2010. Of 10 377 patients analyzed, 71% were white, 21% were black, and 8% were Hispanic. Black and Hispanic patients were more likely to be listed with higher urgency (listing status 1A/1B) in comparison with white patients (P<0.001). Overall, 10.5% of white, 11.6% of black, and 13.4% of Hispanic candidates died on the wait-list or became too sick for a transplant within 1 year of listing. After adjusting for baseline risk factors, Hispanic patients were at higher risk of wait-list mortality (hazard ratio 1.51, 95% CI 1.23, 1.85) in comparison with white patients, but not black patients (hazard ratio 1.13, 95% CI 0.97, 1.31). In comparison with white HT recipients, posttransplant in-hospital mortality was higher in black recipients (odds ratio 1.53, 95% CI 1.15, 2.03) but was not different in Hispanic recipients (odds ratio 0.78, 95% CI 0.48, 1.29). Conclusions-Hispanic patients listed for HT in the United States appear to be at higher risk of dying on the wait-list or becoming too sick for a transplant in comparison with white patients. Black patients are not at higher risk of wait-list mortality, but they have higher early posttransplant mortality. (Circulation. 2012; 125:3022-3030.)

【 授权许可】

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