Adverse-Event Free Survival, Hospitalizations, and Mortality in Left Ventricular Assist Device Recipients: A Rural-Urban Cohort Comparison.

The study used data from one academic medical center in the northeastern United States, so results may not apply to other regions or centers. Rural and urban status was based on the county from the last recorded address at one time, and some recipients may have moved during the study. The registry did not collect geographic location, so addresses were obtained from chart review. Rural and urban groups differed in distance from the implanting center and race, and the analysis did not measure poverty, socioeconomic status, culture, or prior heart failure care. Most recipients were white men, so findings may not apply to more diverse populations. Exclusions removed people who died, were transplanted before discharge, went to hospice, had recent implantations, or lacked county data, which may narrow the sample. The mortality difference was not significant in the unadjusted comparison and appeared only after adjustment.

The authors declared no conflicts of interest.

Do not conclude that rural residence causes more hospitalizations. Rural patients had shorter time to first hospitalization, but when distance from the implanting center was added to the model, the difference became nonsignificant.