Age Is a Predictor of In-Hospital Outcomes for Left Ventricular Assist Device Implantation: A Nationwide Analysis
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...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-02-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/14/3/236 |
| _version_ | 1797240346310082560 |
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| author | Abdul Rahman Akkawi Akira Yamaguchi Junichi Shimamura Omar Chehab Paulino Alvarez Toshiki Kuno Alexandros Briasoulis |
| author_facet | Abdul Rahman Akkawi Akira Yamaguchi Junichi Shimamura Omar Chehab Paulino Alvarez Toshiki Kuno Alexandros Briasoulis |
| author_sort | Abdul Rahman Akkawi |
| collection | DOAJ |
| description | 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 (<i>p</i> = 0.02; 95% confidence interval [CI], 1.12–3.57) and 2.88 (<i>p</i> = 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; <i>p</i> = 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. |
| first_indexed | 2024-04-24T18:05:58Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-04-24T18:05:58Z |
| publishDate | 2024-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-68be8aa675134c08af1db9b555caabe62024-03-27T13:50:02ZengMDPI AGJournal of Personalized Medicine2075-44262024-02-0114323610.3390/jpm14030236Age Is a Predictor of In-Hospital Outcomes for Left Ventricular Assist Device Implantation: A Nationwide AnalysisAbdul Rahman Akkawi0Akira Yamaguchi1Junichi Shimamura2Omar Chehab3Paulino Alvarez4Toshiki Kuno5Alexandros Briasoulis6Department of Internal Medicine, Kansas University School of Medicine-Wichita, Wichita, KS 67214, USADivision of Cardiovascular Surgery, University of Tsukuba, Tsukuba 305-8577, Ibaraki, JapanDivision of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, NY 10595, USADivision of Cardiology, Department of Medicine, Johns Hopkins University Baltimore, Baltimore, MD 21218, USADepartment of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH 44195, USADivision of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USADivision of Cardiovascular Medicine, Section of Heart Failure and Transplantation, University of Iowa, Iowa City, IA 52242, USAThe 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 (<i>p</i> = 0.02; 95% confidence interval [CI], 1.12–3.57) and 2.88 (<i>p</i> = 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; <i>p</i> = 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.https://www.mdpi.com/2075-4426/14/3/236left ventricular assist deviceheart allocation systemin-hospital mortality |
| spellingShingle | Abdul Rahman Akkawi Akira Yamaguchi Junichi Shimamura Omar Chehab Paulino Alvarez Toshiki Kuno Alexandros Briasoulis Age Is a Predictor of In-Hospital Outcomes for Left Ventricular Assist Device Implantation: A Nationwide Analysis Journal of Personalized Medicine left ventricular assist device heart allocation system in-hospital mortality |
| title | Age Is a Predictor of In-Hospital Outcomes for Left Ventricular Assist Device Implantation: A Nationwide Analysis |
| title_full | Age Is a Predictor of In-Hospital Outcomes for Left Ventricular Assist Device Implantation: A Nationwide Analysis |
| title_fullStr | Age Is a Predictor of In-Hospital Outcomes for Left Ventricular Assist Device Implantation: A Nationwide Analysis |
| title_full_unstemmed | Age Is a Predictor of In-Hospital Outcomes for Left Ventricular Assist Device Implantation: A Nationwide Analysis |
| title_short | Age Is a Predictor of In-Hospital Outcomes for Left Ventricular Assist Device Implantation: A Nationwide Analysis |
| title_sort | age is a predictor of in hospital outcomes for left ventricular assist device implantation a nationwide analysis |
| topic | left ventricular assist device heart allocation system in-hospital mortality |
| url | https://www.mdpi.com/2075-4426/14/3/236 |
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