Hospital Complications and Causes of 90-Day Readmissions After Implantation of Left Ventricular Assist Devices

被引:19
|
作者
Tripathi, Byomesh [1 ]
Arora, Shilpkumar [1 ]
Kumar, Varun [1 ]
Thakur, Kamia [2 ]
Lahewala, Sopan [3 ]
Patel, Nileshkumar [4 ]
Dave, Mihir [5 ]
Shah, Mahek [6 ]
Savani, Sejal [5 ]
Sharma, Purnima [1 ]
Bandyopadhyay, Dhrubajyoti [1 ]
Shantha, Ghanshyam Palamaner Subash [7 ]
Egbe, Alexander [11 ]
Chatterjee, Saurav [8 ]
Patel, Nimesh Kirit [9 ]
Gopalan, Radha [5 ]
Figueredo, Vincent M. [10 ]
Deshmukh, Abhishek [11 ]
机构
[1] Mt Sinai St Lukes Roosevelt Hosp Ctr, New York, NY 10025 USA
[2] Geisinger Hlth Syst, Danville, PA USA
[3] Jersey City Med Ctr, Jersey City, NJ USA
[4] Univ Miami, Miller Sch Med, Miami, FL 33136 USA
[5] Icahn Sch Med Mt Sinai, New York, NY 10029 USA
[6] Lehigh Valley Hosp, Allentown, PA USA
[7] Univ Iowa Hosp & Clin, Iowa City, IA 52242 USA
[8] St Francis Hosp & Med Ctr, Hoffman Heart & Vasc Inst, Hartford, CT USA
[9] Virginia Commonwealth Univ, Div Cardiol, Richmond, VA USA
[10] Albert Einstein Med Ctr, Philadelphia, PA 19141 USA
[11] Mayo Clin, Rochester, MN USA
来源
AMERICAN JOURNAL OF CARDIOLOGY | 2018年 / 122卷 / 03期
关键词
MECHANICAL CIRCULATORY SUPPORT; AWAITING HEART-TRANSPLANTATION; CONTINUOUS-FLOW; FAILURE; RISK; CANDIDATES; RECIPIENTS; SURVIVAL; IMPACT; COST;
D O I
10.1016/j.amjcard.2018.04.015
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Left ventricular assist devices (LVADs) have emerged as an attractive option in patients with advance heart failure. Nationwide readmission database 2013 to 2014 was utilized to identify LVAD recipients using ICD-9 procedure code 37.66. The primary outcome was 90-day readmission. Readmission causes were identified using ICD-9 codes in primary diagnosis field. The secondary outcomes were LVAD associated with hospital complications. Hierarchic 2-level logistic models were used to evaluate study outcomes. We identified 4,693 LVAD recipients (mean age 57 years, 76.2% males). Of which 53.9% were readmitted in first 90 days of discharge. Cardiac causes (33.3%), bleeding (21.3%), and infections (12.4%) were leading etiologies of 90-day readmissions. Significant predictors (odds ratio, 95% confidence interval, p value) of readmission were disposition to nursing facilities (1.33, 1.09 to 1.63, p = 0.01) and longer length of stay (1.01, 1.00 to 1.01, p <0.01). Although private insurance (0.75, 0.66 to 0.86, p <0.01), and self-pay (0.58, 0.42 to 0.81, p <0.01) predicted lower readmissions. Cardiac complications (36.3%), major bleeding (29.8%), and postoperative infections (10.4%) were most common LVAD-related complications. In conclusion, high early readmission rate was observed among LVAD recipients with Cardiac complications, bleeding complications, and infections were driving force for major complications and most of readmissions. (C) 2018 Elsevier Inc. All rights reserved.
引用
收藏
页码:420 / 430
页数:11
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