LAUSR

Purpose Cardiovascular disease is the leading cause of death for women in the US. However, 80% of ventricular assist devices (VADs) are implanted in men suggesting gender bias in access or delivery to care for those with advanced heart failure (HF). Racial disparities in disease management also exist. Methods In a retrospective review of patients referred for advanced HF therapy at our center, evaluation status was classified as approved for evaluation or as terminated due to access to insurance, other or unspecified reasons. Race and gender distributions were compared to statewide proportions adjusted for incidence of HF and by evaluation status. A multivariable model of the proportion approved, accounting for gender, age ( Results Of 2893 referred patients, 2085 (72%) were approved for evaluation, 138 (5%) terminated due to insurance access, 108 (4%) other, and 560 (19%) unspecified. Three in 4 referrals were men, indicating a bias relative to statewide data (74% vs. 48%; p Conclusion In this cohort, incoming referral bias toward males was further skewed at entry into the evaluation process for advanced HF therapy. Incoming referral bias toward African Americans is suggested. In 60-69 year-olds, approval for evaluation is skewed toward Caucasians. Understanding this data may help ensure equitable access to advanced HF therapies.