Hospital Readmissions in Left Ventricular Assist Device (LVAD) Recipients: Analysis of Bridge to Transplant (BTT) and Destination Therapy (DT)

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• 作者：M. Bradner¹ ; B.A. Whitson² ; P. Eckman¹ ; A. Lacey¹ ; M. Colvin-Adams¹ ; K.K. Liao¹ ; R. John¹
• 刊名：The Journal of Heart and Lung Transplantation
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：32
• 期：4_supp_S
• 页码：S99
• 全文大小：122 K

文摘

| Figures/TablesFigures/Tables

Methods and Materials

We retrospectively reviewed our prospective database of patients receiving a Heartmate II (HM II) LVAD from 2005-2012 & evaluated readmissions from 1/1/2008 to 6/1/2012. Demographic, clinical and outcome data were analyzed by standard statistical methods. Primary diagnosis for readmission was recorded. Heart transplant admissions were excluded.

Results

200 patients recieved HM II LVAD during the study period; of these, 155 were BTT and 45 DT. There were a total of 300 BTT and 92 DT readmissions. DT patients were older (68 vs. 52 years) as compared to BTT patients (p<0.001). The median (range) readmissions was 1 (0-27) for BTT and 1 (0-19) for DT patients. The proportion of patients with any readmission was 51.6 % for BTT and 57.8 % for DT (p=0.5). The proportion with high recidivism ¡Ý4 readmissions) was 21 % for BTT and 11 % for DT (p=0.15). Gender, diagnosis, 6month, or 1year survival between the 2 groups were similar. 37.5 % of BTT patients were transplanted. The most frequent cause of readmission was infections (19 % BTT vs. 19.6 % DT) followed by bleeding (13 % BTT vs. 16.3 % DT). Readmission rates/100 persons implanted are shown in .

Conclusions

Patients who received DT LVAD were significantly older, but rate of readmissions was not different from BTT patients. Infection and bleeding were the most frequent cause for readmission. Strategies to reduce hospital readmissions are important to improve outcomes as well as quality of life in LVAD recipients.

	BTT	DT	p
Age (Years)	52¡À16	68¡À14	.09
Gender ( % M)	81.4 %	57.8 %	.009
Infection	37	40	.6
All bleeding/anemia	25	33	.7
Hemolysis/thrombosis	14	13	.5
Arrhythmia	4.5	2.2	.2
Pacer/ICD issue	12	6.7	0.2
Pump controller malfunction	7.1	4.4	.3
CHF exacerbation	16	20	.6