Cardiology fellow University of Texas Health Science Center at Houston Houston, Texas, United States
Disclosure(s):
Amna Aijaz, MBBS, MPH: No financial relationships to disclose
Background: Heart-transplant (OHT) centers in the US are concentrated at major academic hospitals in large urban centers, leaving many rural areas and some whole states without a local center. This study aims to visualize the geographic distribution of OHT centers with respect to heart failure morbidity and mortality in the US.
Methods: Data Collection and Management: A list of US heart transplant centers was obtained from the Scientific Registry of Transplant Recipients (SRTR), with their location coordinates verified on individual searches, and websites checked to confirm they all have LVAD capabilities as well. For heart failure-related deaths, data were obtained from CDC Wonder, including the following diagnoses as possible causes of death by state for the year 2022: I40 (Acute myocarditis), I42 (Cardiomyopathy), and I50 (Heart failure). For heart failure hospitalizations, the Healthcare Cost and Utilization Project (HCUP) State Inpatient Data (SID) was used to obtain data for each state individually for the year 2022. The social vulnerability index (SVI) was obtained from the CDC/ATSDR SVI tool using county-level data merged into state-level data with population-weighted means for the year 2022. State maps were obtained from the TIGER/Line Shapefiles by the United States Census Bureau. Population data for each state for the year 2022 were obtained from the United States Census Bureau.
Data Analysis: ArcGIS Pro software was used to build maps, calculate spatial statistics (counts, spatial risk, population risk, of OHT centers, HF deaths, HF hospitalizations), and compute average nearest neighbor distance (NND), spatial autocorrelation Moran's I, and Hot Spot analysis.
Outcome: Maps have been included in the presentation. Detailed interpretation will be provided.
Conclusion: HF morbidity and mortality are clustered regionally, but OHT centers are not, representing a spatial mismatch between HF disease burden and HF-related specialty healthcare. This creates clusters of areas with geographic inequity in terms of access to advanced heart failure therapies.
