Age Is a Predictor of In-Hospital Outcomes for Left Ventricular Assist Device Implantation: A Nationwide Analysis

Author:

Akkawi Abdul Rahman1ORCID,Yamaguchi Akira2ORCID,Shimamura Junichi3,Chehab Omar4,Alvarez Paulino5,Kuno Toshiki6,Briasoulis Alexandros7ORCID

Affiliation:

1. Department of Internal Medicine, Kansas University School of Medicine-Wichita, Wichita, KS 67214, USA

2. Division of Cardiovascular Surgery, University of Tsukuba, Tsukuba 305-8577, Ibaraki, Japan

3. Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, NY 10595, USA

4. Division of Cardiology, Department of Medicine, Johns Hopkins University Baltimore, Baltimore, MD 21218, USA

5. Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH 44195, USA

6. Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA

7. Division of Cardiovascular Medicine, Section of Heart Failure and Transplantation, University of Iowa, Iowa City, IA 52242, USA

Abstract

The 2018 heart allocation system has significantly influenced heart transplantation and left ventricular assist device (LVAD) utilization. Our study aims to investigate age-related outcomes following LVAD implantation in the post-allocation era. Using the National Inpatient Sample, we analyzed data from 7375 patients who underwent LVAD implantation between 2019 and 2020. The primary endpoint was in-hospital mortality following LVAD implantation, stratified by age categories. The age groups were 18–49, 50–59, 60–69, and over 70. These represented 26%, 26%, 31%, and 17% of patients, respectively. Patients aged 60–69 and those over 70 exhibited higher in-hospital mortality rates of 12% and 17%, respectively, compared to younger age groups (7% for 18–49 and 6% for 50–59). The age groups 60–69 and over 70 were independent predictors of mortality, with adjusted odds ratios of 1.99 (p = 0.02; 95% confidence interval [CI], 1.12–3.57) and 2.88 (p = 0.002; 95% CI, 1.45–5.71), respectively. Additionally, a higher Charlson Comorbidity Index was associated with increased in-hospital mortality risk (adjusted odds ratio 1.39; p = 0.02; 95% CI, 1.05–1.84). Additionally, patients above 70 experienced a statistically shorter length of stay. Nonhome discharge was found to be significantly high across all age categories. However, the difference in hospitalization cost was not statistically significant across the age groups. Our study highlights that patients aged 60 and above face an increased risk of in-hospital mortality following LVAD implantation in the post-allocation era. This study sheds light on age-related outcomes and emphasizes the importance of considering age in LVAD patient selection and management strategies.

Publisher

MDPI AG

Reference37 articles.

1. OPTN/SRTR 2018 Annual Data Report: Heart;Colvin;Am. J. Transpl.,2020

2. Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients: Results from the ROADMAP Study;Estep;J. Am. Coll. Cardiol.,2015

3. Durable Left Ventricular Assist Device as a Bridge to Heart Transplantation under the New Donor Heart Allocation System;Nordan;ASAIO J.,2021

4. A change of heart: Preliminary results of the US 2018 adult heart allocation revision;Goff;Am. J. Transpl.,2020

5. Organ Procurement and Transplantation Network (2023, May 22). Adult Heart Allocation, Available online: https://optn.transplant.hrsa.gov/professionals/by-organ/heart-lung/adult-heart-allocation/.

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3