In-hospital mortality in older patients after ventricular assist device implantation: A national cohort study

The Journal of Thoracic and Cardiovascular Surgery

Richard D. Urman¹  Charlotta Lindvall²  Devvrat Malhotra³  David A. D'Alessandro⁴  Brooks Udelsman⁵  Ethan Y. Brovman⁶ 

[1] Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Mass;Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Mass;Department of Surgery, Massachusetts General Hospital, Boston, Mass;Division of Cardiac Surgery, Massachusetts General Hospital, Boston, Mass;Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass;Harvard School of Public Health, Boston, Mass

关键词: ventricular assist device;    population-level analysis;    geriatric;   

DOI  :  10.1016/j.jtcvs.2018.10.142

学科分类：心脏病和心血管学

来源: Mosby, Inc.

【 摘 要 】

ObjectivesTo assess baseline patient characteristics and identify factors associated with in-hospital mortality after ventricular assist device (VAD) placement.MethodsCross-sectional study using the National Inpatient Sample database from January 2010 to December 2014. Analyses were performed with sample weights provided by the National Inpatient Sample, which are reported ± the standard error of the mean.ResultsWeighted samples yielded 15,021 ± 1111 patients who received a VAD. The mean age at time of implantation was 56.6 years. Most recipients were white (59.9%) and male (75.0%). Among older patients, in-hospital mortality increased from 17.2% to 48.2% when 1 or more high-risk interventions (cardiac surgery, prolonged mechanical ventilation, hemodialysis, or extracorporeal membrane oxygenation) preceded VAD placement (P ConclusionsOlder patients who underwent 1 or more intensive treatments before VAD placement had a nearly 50% inpatient mortality and were unlikely to receive a cardiac transplantation. Refining patient selection might help better align VAD with those most likely to benefit.

【 授权许可】

Unknown