Patients undergoing heart transplantation require intensive long-term medical management, and social determinants of health may influence post-transplant outcomes. A retrospective cohort study published in the Journal of Cardiac Failure evaluated whether race, sex, socioeconomic status (SES), and educational attainment were associated with rehospitalization risk during the first year after heart transplantation (HT).

The analysis included adult heart transplant recipients treated between January 2005 and December 2022. Investigators collected demographic characteristics, educational attainment, insurance status, primary language, and SES index derived from patient zip codes. Rates and causes of readmission during the first post-transplant year were compared across demographic and socioeconomic groups using multivariable Cox regression models.

Findings

• Nearly one-third of recipients had a high school education or lower.
• Six percent of patients died during the index hospitalization.
• Fifty percent of recipients were rehospitalized within the first year after heart transplantation.
• Infection accounted for 39% of readmissions, while rejection accounted for 20%.
• After multivariable adjustment, race, sex, and SES tertile were not independently associated with first-year hospitalization risk.
• Lower educational attainment was independently associated with increased rehospitalization risk: HR 1.41 (95% CI 1.07–1.87; p=0.016).

In this single-center heart transplant cohort, lower educational attainment was associated with higher risk of rehospitalization during the first post-transplant year, whereas race, sex, and socioeconomic status were not independent predictors after adjustment.