The use of generalized additive models revealed similar relationships between distance and the probability of listing, before and after LAS implementation (Figure 1). The same results were found when previously advocated distance quantiles were used (7), and when centers instead of regions were included as fixed effects in the models. Prior to LAS implementation, RUCA category was not associated with the probability of being listed, but this relationship became significant after LAS implementation (Table 3). The interaction between RUCA category and period (pre or post-LAS) was not significant (p = 0.38). Rates of listing were higher for white than for nonwhite people across distance strata both before and after LAS implementation (Table 2). Further, the effects of distance on listing probabilities were greater among nonwhite people. The pre-LAS relative risks of being listed were 0.87 per 100 miles (0.84�C0.91) for white people and 0.50 CB-839 manufacturer
per 100 miles (0.45�C0.56) for nonwhite people (distance-by-race p < 0.001). After LAS implementation, the relative risks of being listed were 0.84 per 100 miles (0.81�C0.87) for white people and 0.47 per 100 miles (0.42�C0.53) for nonwhite people (distance-by-race p < 0.001). Once wait-listed, median time to transplantation was see more
647 days (95%: 616�C672) in the pre-LAS period with cumulative incidences of LT at 1 month, 3 months, 6 months and 12 months of 5.1% (95% CI: 4.6�C5.6), 12.9% (12.1�C13.6), 21.5% (20.6�C22.5) and 33.2% (32.1�C34.3), respectively. In the post-LAS period, median time to transplant was reduced to 136 days (p < 0.001), with higher cumulative incidences noted at 1 month, 3 months, 6 months and 12 months [22.4% (95% CI: 21.4�C23.4), 40.5% (39.3�C41.7), 52.6% (51.4�C53.8) and 63.1% (61.9�C64.3), respectively]. Figure 2 shows the cumulative incidence of transplantation over time based on quartiles of distance from the closest LT center, before and after LAS implementation. In unadjusted Cox model analyses, distance from the closest LT center was not associated with the time to transplant, conditional on listing, C59 wnt
in the pre-LAS period (HR = 1.03 for a 100 miles increment, 95% CI: 0.99�C1.08; p = 0.19) or post-LAS period (HR = 1.03 for a 100 miles increment, 95% CI: 0.99�C1.08; p = 0.13). Adjusted models revealed similar results in the pre-LAS (HR = 0.96, 95% CI: 0.91�C1.01; p = 0.15) and post-LAS (HR = 1.02, 95% CI: 0.97�C1.07; p = 0.39) periods. One-month, 1 and 3-year survival rates were 95.2% (94.5�C95.9), 81.9% (80.6�C83.1) and 65.1% (63.5�C66.7) in the pre-LAS period; this survival did not differ (p = 0.08) to that observed after LAS implementation: 95.3% (94.7�C96.0), 82.1% (80.7�C83.4) and 59.5% (56.3�C62.9).