{"id":"https://openalex.org/W7223676664","doi":"https://doi.org/10.64898/2026.10.22.26366273","title":"Urban, regional and remote outcomes following TAVR for Queensland patients: a retrospective cohort study","display_name":"Urban, regional and remote outcomes following TAVR for Queensland patients: a retrospective cohort study","publication_year":2026,"publication_date":"2026-10-26","ids":{"openalex":"https://openalex.org/W7223676664","doi":"https://doi.org/10.64898/2026.10.22.26366273"},"language":"en","primary_location":{"id":"doi:10.64898/2026.10.22.26366273","doi":"https://doi.org/10.64898/2026.10.22.26366273","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.10.22.26366273","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/10/26/2026.10.22.26366273.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/10/26/2026.10.22.26366273.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5060006887","display_name":"Patrick Cameron","orcid":"https://orcid.org/0009-0000-3954-3860","observed_orcids":["https://orcid.org/0009-0000-3954-3860","https://orcid.org/0009-0000-3767-9035"]},"institutions":[{"id":"https://openalex.org/I86467917","display_name":"James Cook University","ror":"https://ror.org/04gsp2c11","country_code":"AU","type":"education","lineage":["https://openalex.org/I86467917"]}],"countries":["AU"],"is_corresponding":true,"raw_author_name":"Patrick Cameron","raw_affiliation_strings":["James Cook University, Address: College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia"],"raw_orcid":"https://orcid.org/0009-0000-3767-9035","affiliations":[{"raw_affiliation_string":"James Cook University, Address: College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia","institution_ids":["https://openalex.org/I86467917"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5028148611","display_name":"Anthony Brazzale","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Anthony Brazzale","raw_affiliation_strings":["Northern Heart Specialists, Address: Level 1/144 Lake St, Cairns North QLD 4870"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Northern Heart Specialists, Address: Level 1/144 Lake St, Cairns North QLD 4870","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5064499043","display_name":"Greg Starmer","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Greg Starmer","raw_affiliation_strings":["Northern Heart Specialists, Address: Level 1/144 Lake St, Cairns North QLD 4870"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Northern Heart Specialists, Address: Level 1/144 Lake St, Cairns North QLD 4870","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5020092364","display_name":"Joseph Vaughan Moxon","orcid":"https://orcid.org/0000-0002-2131-2068","observed_orcids":["https://orcid.org/0000-0002-2131-2068"]},"institutions":[{"id":"https://openalex.org/I86467917","display_name":"James Cook University","ror":"https://ror.org/04gsp2c11","country_code":"AU","type":"education","lineage":["https://openalex.org/I86467917"]}],"countries":["AU"],"is_corresponding":false,"raw_author_name":"Joseph V Moxon","raw_affiliation_strings":["James Cook University, Address: College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"James Cook University, Address: College of Medicine and Dentistry, James Cook University, Townsville, QLD 4811, Australia","institution_ids":["https://openalex.org/I86467917"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5060006887"],"corresponding_institution_ids":["https://openalex.org/I86467917"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10172","display_name":"Cardiac Valve Diseases and Treatments","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10172","display_name":"Cardiac Valve Diseases and Treatments","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10618","display_name":"Aortic Disease and Treatment Approaches","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11551","display_name":"Infective Endocarditis Diagnosis and Management","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/transcatheter-aortic-valve-replacement","display_name":"transcatheter aortic valve implantation","score":1.0},{"id":"https://openalex.org/keywords/severe-aortic-stenosis","display_name":"severe aortic stenosis","score":0.9269999861717224},{"id":"https://openalex.org/keywords/rurality","display_name":"rurality","score":0.9269999861717224},{"id":"https://openalex.org/keywords/rural-health-care-access","display_name":"rural healthcare access","score":0.7540000081062317},{"id":"https://openalex.org/keywords/12-month-mortality","display_name":"12-month mortality","score":0.8650000095367432},{"id":"https://openalex.org/keywords/queensland","display_name":"Queensland","score":0.3610000014305115},{"id":"https://openalex.org/keywords/clinical-frailty-scale","display_name":"Clinical Frailty Scale","score":0.734000027179718},{"id":"https://openalex.org/keywords/chronic-lung-disease","display_name":"chronic lung disease","score":0.8360000252723694},{"id":"https://openalex.org/keywords/atrial-fibrillation","display_name":"atrial fibrillation","score":0.8880000114440918},{"id":"https://openalex.org/keywords/sts-score","display_name":"STS score","score":0.8019999861717224},{"id":"https://openalex.org/keywords/health-equity","display_name":"health equity","score":0.7160000205039978}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9018999934196472},{"id":"https://openalex.org/C2779465365","wikidata":"https://www.wikidata.org/wiki/Q7380600","display_name":"Rurality","level":3,"score":0.8623999953269958},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.7017999887466431},{"id":"https://openalex.org/C158739034","wikidata":"https://www.wikidata.org/wiki/Q1907114","display_name":"Metropolitan area","level":2,"score":0.5164999961853027},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.4697999954223633},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.4627000093460083},{"id":"https://openalex.org/C2780026749","wikidata":"https://www.wikidata.org/wiki/Q7912830","display_name":"Valve replacement","level":3,"score":0.46209999918937683},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.45320001244544983},{"id":"https://openalex.org/C2779161974","wikidata":"https://www.wikidata.org/wiki/Q815819","display_name":"Atrial fibrillation","level":2,"score":0.45249998569488525},{"id":"https://openalex.org/C2780007028","wikidata":"https://www.wikidata.org/wiki/Q2343082","display_name":"Stenosis","level":2,"score":0.4359999895095825},{"id":"https://openalex.org/C50382708","wikidata":"https://www.wikidata.org/wiki/Q223218","display_name":"Proportional hazards model","level":2,"score":0.34689998626708984},{"id":"https://openalex.org/C129047720","wikidata":"https://www.wikidata.org/wiki/Q175185","display_name":"Rural area","level":2,"score":0.34310001134872437},{"id":"https://openalex.org/C2781414266","wikidata":"https://www.wikidata.org/wiki/Q531019","display_name":"Aortic valve stenosis","level":3,"score":0.34040001034736633},{"id":"https://openalex.org/C2778213512","wikidata":"https://www.wikidata.org/wiki/Q844935","display_name":"Coronary artery disease","level":2,"score":0.3118000030517578},{"id":"https://openalex.org/C2776570981","wikidata":"https://www.wikidata.org/wiki/Q4413093","display_name":"Aortic valve replacement","level":3,"score":0.3037000000476837},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.29580000042915344},{"id":"https://openalex.org/C2780714102","wikidata":"https://www.wikidata.org/wiki/Q616071","display_name":"Aortic valve","level":2,"score":0.29499998688697815},{"id":"https://openalex.org/C2780877353","wikidata":"https://www.wikidata.org/wiki/Q2518253","display_name":"Health services research","level":3,"score":0.28619998693466187},{"id":"https://openalex.org/C2780454255","wikidata":"https://www.wikidata.org/wiki/Q7111916","display_name":"Outcomes research","level":3,"score":0.2808000147342682},{"id":"https://openalex.org/C2780074459","wikidata":"https://www.wikidata.org/wiki/Q389735","display_name":"Heart disease","level":2,"score":0.27059999108314514},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.2597000002861023}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.10.22.26366273","doi":"https://doi.org/10.64898/2026.10.22.26366273","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.10.22.26366273","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/10/26/2026.10.22.26366273.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.10.22.26366273","doi":"https://doi.org/10.64898/2026.10.22.26366273","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.10.22.26366273","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/10/26/2026.10.22.26366273.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":null,"license_id":null,"version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"},{"score":0.7578999996185303,"display_name":"Reduced inequalities","id":"https://metadata.un.org/sdg/10"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7223676664.pdf","grobid_xml":"https://content.openalex.org/works/W7223676664.grobid-xml"},"referenced_works_count":24,"referenced_works":["https://openalex.org/W1575075233","https://openalex.org/W1996747177","https://openalex.org/W2018835811","https://openalex.org/W2091753633","https://openalex.org/W2109039504","https://openalex.org/W2122694177","https://openalex.org/W2149609916","https://openalex.org/W2158834735","https://openalex.org/W2534605893","https://openalex.org/W2885750278","https://openalex.org/W2888601457","https://openalex.org/W2899618340","https://openalex.org/W2903458882","https://openalex.org/W2908126157","https://openalex.org/W2944567095","https://openalex.org/W2988400654","https://openalex.org/W3012810686","https://openalex.org/W3101796377","https://openalex.org/W3198010327","https://openalex.org/W3206503828","https://openalex.org/W4223415237","https://openalex.org/W4384627388","https://openalex.org/W4389849863","https://openalex.org/W4408586696"],"related_works":["https://openalex.org/W7171845348","https://openalex.org/W2882987718","https://openalex.org/W2944567095","https://openalex.org/W4389849863","https://openalex.org/W4295850046","https://openalex.org/W4295539185","https://openalex.org/W7160060354","https://openalex.org/W2808025472","https://openalex.org/W7171817429","https://openalex.org/W2220644200"],"abstract_inverted_index":{"Abstract":[0],"Background":[1],"Transcatheter":[2],"aortic":[3,15,276,294,299],"valve":[4,277,295,300],"replacement":[5,278],"(TAVR)":[6],"offers":[7],"a":[8,55,156,388,495],"minimally":[9],"invasive":[10],"approach":[11],"to":[12,239,285,464,500,553,558],"treat":[13],"severe":[14,177,438],"stenosis":[16],"(AS)":[17],"but":[18,375],"can":[19],"only":[20,225,359,513],"be":[21],"performed":[22],"at":[23,440,541],"centres":[24],"meeting":[25],"strict":[26],"regulatory":[27],"requirements.":[28],"It":[29],"remains":[30],"unclear":[31],"whether":[32,45],"this":[33,259,382,449],"requirement":[34],"restricts":[35],"TAVR":[36,74,207,220,230,314,396,455,477],"access":[37],"for":[38,265,358],"patients":[39,170,227,236,357,374,386,426,508,515,526,531],"residing":[40],"in":[41,159,255,328,417,462,538],"rural":[42,235,331,525],"Australia,":[43],"and":[44,78,95,111,116,132,168,179,197,231,272,313,320,332,344,348,362,372,403,409,416,424,435,459,470,520,527,550,561],"such":[46],"people":[47,473,491],"experience":[48],"poorer":[49],"outcomes":[50,208,273,456,504],"than":[51,183],"metropolitan":[52],"counterparts":[53],"as":[54,97],"result.":[56],"Methods":[57],"This":[58,420],"multicentre":[59],"retrospective":[60],"cohort":[61],"study":[62,260,355,369,383,453],"used":[63,350,363],"Australian":[64,368],"Cardiac":[65],"Outcomes":[66],"Registry":[67],"data.":[68],"All":[69],"Queensland":[70,405,482],"residents":[71,406,469],"who":[72,228,492,516],"underwent":[73,229],"between":[75,211,270,330,400],"April":[76],"2018":[77],"27":[79],"March":[80],"2026":[81,287],"were":[82,127,171,209,337,474],"included.":[83],"Rurality":[84],"was":[85,108,112,248,421],"assigned":[86],"by":[87,142,457],"postcode":[88],"using":[89,114,288],"the":[90,163,268,289,318,441,444,451,460,481,487,518,521,539,562],"Modified":[91],"Monash":[92],"Model":[93],"(MMM)":[94],"grouped":[96],"urban":[98,184,333,371],"(MMM1),":[99],"regional":[100,167,373,423],"(MMM2\u20134),":[101],"or":[102,195,243,251,544],"remote":[103,169,377,404,425,466,530],"(MMM5\u20137).":[104],"The":[105,353,367],"primary":[106],"outcome":[107],"12-month":[109,204,392],"mortality":[110,138,329,394],"investigated":[113],"Kaplan-Meier":[115],"Cox":[117],"proportional":[118],"hazards":[119],"analyses.":[120,419],"Findings":[121],"Among":[122,490],"6813":[123,385],"patients,":[124,346],"4246":[125],"(62%)":[126],"urban,":[128,401],"2092":[129],"(31%)":[130],"regional,":[131,402],"475":[133],"(7%)":[134],"remote.":[135],"Twelve-month":[136],"all-cause":[137,393],"did":[139,397],"not":[140,376,398],"differ":[141,399],"rurality":[143,212,271,312,458],"(urban:":[144],"211":[145],"[5.0%];":[146],"regional:":[147],"103":[148],"[4.9%];":[149],"remote:":[150],"23":[151],"[4.8%];":[152],"\u03c7\u00b2=0.991,":[153],"log-rank":[154],"P=0.929),":[155],"finding":[157],"confirmed":[158],"multivariable":[160,414],"analysis.":[161,352],"At":[162],"time":[164,442],"of":[165,311,381,443,454,485,506,524,529,567],"TAVR,":[166,494],"younger,":[172,428],"more":[173,176,430,437],"comorbid,":[174],"had":[175],"AS,":[178],"lower":[180,432],"STS":[181,191,433],"scores":[182],"counterparts.":[185],"Clinical":[186],"frailty":[187],"score,":[188,192],"non-transfemoral":[189],"access,":[190,560],"atrial":[193],"fibrillation":[194],"flutter,":[196],"moderate\u2013severe":[198],"chronic":[199],"lung":[200],"disease":[201],"independently":[202],"predicted":[203],"mortality.":[205],"Interpretation":[206],"comparable":[210,502],"groups,":[213],"suggesting":[214],"equitable":[215],"care":[216],"within":[217],"Queensland\u2019s":[218],"centralised":[219,496],"model.":[221],"However,":[222,335,510],"registry":[223],"data":[224,512,552,555],"captures":[226,514],"may":[232,535],"miss":[233],"older":[234],"facing":[237],"barriers":[238,534],"AS":[240,439,569],"diagnosis,":[241,542],"referral,":[242,543],"procedural":[244,390,554],"workup.":[245],"Funding":[246],"There":[247],"no":[249,326],"funding":[250],"sponsor":[252],"involvement.":[253],"Research":[254],"context":[256],"Evidence":[257],"before":[258],"We":[261,280,306],"searched":[262,281],"Medline":[263],"(Ovid)":[264],"publications":[266],"examining":[267],"association":[269],"after":[274,395,413],"transcatheter":[275],"(TAVR).":[279],"from":[282,317,322,387],"database":[283],"inception":[284],"September":[286],"terms":[290],"\u201cTAVR\u201d":[291],"OR":[292,297,302],"\u201ctranscatheter":[293,298],"replacement\u201d":[296],"implantation\u201d":[301],"\u201cTAVI\u201d,":[303],"AND":[304],"\u201crural*\u201d.":[305],"identified":[307],"two":[308],"key":[309],"studies":[310,339],"outcomes,":[315],"one":[316,321],"USA":[319],"Australia.":[323],"Both":[324],"reported":[325],"difference":[327],"patients.":[334,378,467],"both":[336],"single-centre":[338],"with":[340,480],"small":[341],"samples":[342],"(413":[343],"142":[345],"respectively)":[347],"neither":[349],"time-to-event":[351],"US":[354],"followed":[356],"6":[360],"months":[361],"descriptive":[364],"analysis":[365],"alone.":[366],"included":[370],"Added":[379],"value":[380],"In":[384],"national":[389],"registry,":[391],"(5.0%,":[407],"4.9%,":[408],"4.8%,":[410],"respectively),":[411],"including":[412],"adjustment":[415],"sensitivity":[418],"despite":[422],"being":[427],"having":[429,436],"comorbidity,":[431],"scores,":[434],"procedure.":[445],"To":[446],"our":[447],"knowledge,":[448],"is":[450,556],"largest":[452],"first":[461],"Australia":[463],"include":[465],"Remote":[468],"First":[471],"Nations":[472],"underrepresented":[475],"among":[476],"recipients":[478],"compared":[479],"population.":[483],"Implications":[484],"all":[486],"available":[488],"evidence":[489],"reach":[493],"delivery":[497],"model":[498],"appears":[499],"provide":[501],"short-term":[503],"regardless":[505],"where":[507],"live.":[509],"ACOR":[511],"received":[517],"procedure,":[519],"younger":[522],"age":[523],"underrepresentation":[528],"suggests":[532],"that":[533],"exist":[536],"earlier":[537],"pathway,":[540],"work-up.":[545],"Future":[546],"research":[547],"linking":[548],"diagnostic":[549],"referral":[551],"needed":[557],"assess":[559],"findings":[563],"should":[564],"inform":[565],"planning":[566],"non-metropolitan":[568],"services.":[570]},"counts_by_year":[],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-10-27T00:00:00"}
