Heart Failure
Social Determinants of Health, Race, and Sex on Risk for Readmission After Heart Transplantation
- Authors: Single-center cohort
- Journal / date: Journal of Cardiac Failure, 2026
- DOI / URL: 10.1016/j.cardfail.2026.04.016 | PMID 42140574
- Source basis: Abstract only
- Study type: Single-center retrospective cohort
- Population: 1139 adult HT recipients (Jan 2005-Dec 2022); 26% women, 24% Non-Hispanic Black, 16% Hispanic, 43% public insurance, 9.7% non-English-speaking
- Key findings:
- 6% in-hospital mortality at index admission
- 50% readmitted within 1 year (leading causes: infection 39%, rejection 20%)
- Sex, race, and SES tertile did NOT predict 1-year readmission after adjustment
- Lower educational attainment did: adjusted HR 1.41 (95% CI 1.07-1.87, p=0.016)
- Why it matters (clinical takeaway):
- Confirms that education level — a proxy for health literacy — is a stronger and more modifiable readmission risk factor than commonly cited demographics.
- Pre-transplant evaluation should screen for health literacy and offer structured, tiered post-HT teaching (medication management, rejection signs, when-to-call) for patients with lower attainment.
- Reinforces caution against using race or SES tertile as risk modifiers in HT decision-making — they did not predict outcomes here.
- Caveats / limitations: Single center, retrospective. Education is a coarse health-literacy proxy.
- Referenced trials pulled forward: None.