TABLE 2.
Characteristics of Candidates at Risk for Potential Overtreatment by Center of Listing
| All At-Risk Candidates 108 Centers (N = 12,762) | Bottom Quartile 27 Centers (n = 2,345) | Top Quartile 28 Centers (n = 3,203) | p Value | |
|---|---|---|---|---|
| Potentially overtreated | 1,471 (11.6) | 50 (2.1) | 884 (27.6) | <0.001 |
|
| ||||
| Median time to transplantation | 260 [67–844] | 412 [138–1,124] | 146 [38–539] | 0.002 |
|
| ||||
| Survival from listing | 0.006 | |||
| 1 yr | 84.5 (83.8–85.2) | 82.6 (80.9–84.1) | 85.5 (84.2–86.7) | |
| 3 yrs | 73.3 (72.4–74.2) | 69.6 (67.3–71.8) | 76.3 (74.4–78.0) | |
|
| ||||
| Post-transplantation survival | 0.083 | |||
| 1 yr | 91.0 (90.2–91.6) | 88.4 (86.3–90.2) | 91.9 (90.6–93.0) | |
| 3 yrs | 84.7 (83.7–85.7) | 82.7 (80.1–85.0) | 86.5 (84.7–88.2) | |
|
| ||||
| Age at listing, yrs | 53±12 | 53±13 | 54±12 | 0.039 |
|
| ||||
| Height, cm | 174±10 | 174±10 | 173±10 | 0.189 |
|
| ||||
| Weight, kg | 83±18 | 84±18 | 81±18 | 0.098 |
|
| ||||
| Cardiac index, ml/kg/m2 | 2.17±0.63 | 2.12±0.62 | 2.25±0.63 | 0.014 |
|
| ||||
| Mean PAP, mm Hg | 30±10 | 31±10 | 30±10 | 0.221 |
|
| ||||
| Mean PCWP, mm Hg | 20±8 | 20±8 | 20±9 | 0.333 |
|
| ||||
| Diagnosis | 0.455 | |||
| Dilated cardiomyopathy | 5,174 (41) | 960 (41) | 1,340 (42) | |
| Ischemic cardiomyopathy | 4,335 (34) | 761 (32) | 1,144 (36) | |
| Restrictive cardiomyopathy | 1,579 (12) | 265 (11) | 321 (10) | |
| Other | 1,674 (13) | 359 (15) | 398 (12) | |
|
| ||||
| Blood type O | 5,448 (43) | 990 (42) | 1,365 (43) | 0.928 |
|
| ||||
| Female | 3,550 (28) | 621 (26) | 906 (28) | 0.275 |
|
| ||||
| Karnofsky performance status | ||||
| Limited impairment, 10%–30% | 4,292 (34) | 972 (41) | 748 (23) | 0.003 |
| Moderate impairment, 40%–60% | 4,905 (38) | 741 (32) | 1,135 (35) | |
| Severe impairment, 70%–100% | 3,191 (25) | 616 (26) | 1,172 (37) | |
| Unknown/missing | 374 (3) | 16 (1) | 148 (5) | |
|
| ||||
| Working for income | 1,696 (13) | 312 (13) | 325 (10) | 0.073 |
|
| ||||
| Race | 0.986 | |||
| White | 8,448 (66) | 1,478 (63) | 1,988 (62) | |
| Black | 2,716 (21) | 515 (22) | 697 (22) | |
| Hispanic | 1,058 (8) | 233 (10) | 337 (11) | |
| Other | 540 (4) | 119 (5) | 181 (6) | |
|
| ||||
| College or higher education | 6,987 (55) | 1,292 (55) | 1,626 (51) | 0.181 |
|
| ||||
| Insurance type | 0.419 | |||
| Private | 6,733 (53) | 1,083 (46) | 1,675 (52) | |
| Medicaid | 1,336 (10) | 330 (14) | 372 (12) | |
| Medicare | 4,177 (33) | 830 (35) | 1,027 (32) | |
| Other | 516 (4) | 102 (4) | 129 (4) | |
|
| ||||
| BMI, kg/m2 | 0.088 | |||
| <25 | 3,812 (30) | 689 (29) | 1,061 (33) | |
| 25–29 | 4,629 (36) | 823 (35) | 1,176 (37) | |
| 30–34 | 3,289 (26) | 617 (26) | 731 (23) | |
| ≥35 | 1,032 (8) | 216 (9) | 235 (7) | |
|
| ||||
| Diabetes | 3,653 (29) | 667 (28) | 949 (30) | 0.619 |
|
| ||||
| Renal function | 0.352 | |||
| ≥60 ml/min/1.73 m2 | 6,693 (52) | 1,215 (52) | 1,699 (53) | |
| 30–59 ml/min/1.73 m2 | 5,118 (40) | 971 (41) | 1,247 (39) | |
| <30 ml/min/1.73 m2 | 579 (5) | 96 (4) | 147 (5) | |
| On dialysis | 372 (3) | 63 (3) | 110 (3) | |
|
| ||||
| Smoking history | 5,795 (45) | 1,124 (48) | 1,355 (42) | 0.215 |
|
| ||||
| CVA history | 688 (5) | 112 (5) | 142 (4) | 0.713 |
|
| ||||
| History of malignancy | 1,071 (8) | 200 (9) | 237 (7) | 0.357 |
|
| ||||
| History of cardiac surgery | 4,210 (33) | 840 (36) | 1,136 (35) | 0.907 |
|
| ||||
| Defibrillator in place | 10,137 (79) | 1,950 (83) | 2,459 (77) | 0.016 |
Values n (%), median [interquartile range], % (95% CI), or mean±SD. Candidates not at risk of potential overtreatment or with missing data (n = 7,157) were excluded (see Figure 1). The p values for comparisons for between top and bottom quartiles of overtreatment were calculated with robust SE clustered by center.
BMI = body mass index; CI = confidence interval; CVA = cerebrovascular accident; PAP = pulmonary artery pressure; PCWP = pulmonary capillary wedge pressure.