Abstract 4143206: Gender Disparities in Heart Transplant Outcomes for Heart Failure Patients: Insights from the National Inpatient Sample Dataset

Background: Heart failure is a leading cause of morbidity and mortality globally, and heart transplantation remains a definitive treatment for end-stage heart failure. Previous studies have suggested potential gender disparities in access to and outcomes of heart transplantation, but comprehensive analyses using large datasets are limited. Objective: This study aims to investigate gender disparities in heart transplant outcomes among heart failure patients using the National Inpatient Sample (NIS) dataset. Methods: Using the National Inpatient Sample NIS dataset (2017-2020), we analyzed data from 11,025 heart failure patients who underwent heart transplantation, with 7,920 males and 3,105 females. Demographic characteristics, comorbidities, and clinical outcomes were compared between genders. Multivariate analyses were conducted to adjust for potential confounders. Results: In this study, females undergoing heart transplant were significantly younger than males (51.6 ± 29.8 vs. 55.0 ± 26.4 years, p < 0.001). Males exhibited higher incidences of comorbid conditions including hypertension (80.7% vs. 69.7%), diabetes (37.3% vs. 24.8%), and ischemic heart disease (43.4% vs. 26.3%) (all p < 0.001). Both genders had comparable odds of in-hospital mortality (OR 0.98, 95% CI 0.80-1.19, p = 0.842) and mechanical ventilation requirements (OR 1.04, 95% CI 0.93-1.17, p = 0.509). Additionally, the length of hospital stay (difference -2.09 days, 95% CI -3.81 to -0.37, p = 0.223) and hospital charges (difference $31,645, 95% CI -$15,309 to $78,599, p = 0.044) were similar between genders. However, females had significantly higher odds of post-transplant complications such as vasopressor requirements (OR 1.14, 95% CI 1.03-1.26, p = 0.014), stroke (OR 1.22, 95% CI 1.01-1.47, p = 0.044), and vascular complications (OR 1.35, 95% CI 1.17-1.57, p < 0.001). Conclusion: These findings suggest that while age and pre-existing conditions vary by gender, in-hospital outcomes are largely similar, though females may face higher risks of specific post-transplant complications.