The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices
We aimed to identify a simple metric accounting for peri-procedural hemoglobin changes, independent of blood product transfusion strategies, and assess its correlation with outcomes in patients undergoing left ventricular assist device (LVAD) implantation We included consecutive patients undergoing...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/15/4517 |
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| author | Supriya Shore Thomas C. Hanff Jeremy A. Mazurek Arieh Fox Monique S. Tanna Edward W. Grandin Robert Zhang Joyce Wald Carli Peters Michael A. Acker Pavan Atluri J. Eduardo Rame Lee R. Goldberg Mariell Jessup Kenneth B. Margulies Edo Y. Birati |
| author_facet | Supriya Shore Thomas C. Hanff Jeremy A. Mazurek Arieh Fox Monique S. Tanna Edward W. Grandin Robert Zhang Joyce Wald Carli Peters Michael A. Acker Pavan Atluri J. Eduardo Rame Lee R. Goldberg Mariell Jessup Kenneth B. Margulies Edo Y. Birati |
| author_sort | Supriya Shore |
| collection | DOAJ |
| description | We aimed to identify a simple metric accounting for peri-procedural hemoglobin changes, independent of blood product transfusion strategies, and assess its correlation with outcomes in patients undergoing left ventricular assist device (LVAD) implantation We included consecutive patients undergoing LVAD implantation at a single center between 10/1/2008 and 6/1/2014. The anemia stress index (ASI), defined as the sum of number of packed red blood cells transfused and the hemoglobin changes after LVAD implantation, was calculated for each patient at 24 h, discharge, and 3 months after LVAD implantation. Our cohort included 166 patients (80.1% males, mean age 56.3 ± 15.6 years) followed up for a median of 12.3 months. Increases in ASI per unit were associated with a higher hazard for all-cause mortality and early RV failure. The associations between the ASI and all-cause mortality persisted after multivariable adjustment, irrespective of when it was calculated (adjusted HR of 1.11, 95% CI 1.03–1.20 per unit increase in ASI). Similarly, ASI at 24 h after implant was associated with early RV failure despite multivariable adjustment (OR 1.09, 95% CI 1.05–1.14). We present a novel metric, the ASI, that is correlated with an increased risk for all-cause mortality and early RV failure in LVAD recipients. |
| first_indexed | 2024-03-09T10:07:41Z |
| format | Article |
| id | doaj.art-99d4ab1f11ad4216bea9510400485d41 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T10:07:41Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-99d4ab1f11ad4216bea9510400485d412023-12-01T22:59:55ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011115451710.3390/jcm11154517The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist DevicesSupriya Shore0Thomas C. Hanff1Jeremy A. Mazurek2Arieh Fox3Monique S. Tanna4Edward W. Grandin5Robert Zhang6Joyce Wald7Carli Peters8Michael A. Acker9Pavan Atluri10J. Eduardo Rame11Lee R. Goldberg12Mariell Jessup13Kenneth B. Margulies14Edo Y. Birati15Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI 48109, USADivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA 19104, USADivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA 19104, USAThe Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USADivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA 19104, USADivision of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USADepartment of Internal Medicine, University of Pennsylvania, Philadelphia, PA 19104, USADivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA 19104, USADivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA 19104, USADivision of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, PA 19104, USADivision of Cardiovascular Surgery, University of Pennsylvania, Philadelphia, PA 19104, USAJefferson Heart Institute, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USADivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA 19104, USAAmerican Heart Association, Dallas, TX 75231, USADivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA 19104, USADivision of Cardiovascular Medicine, University of Pennsylvania, Philadelphia, PA 19104, USAWe aimed to identify a simple metric accounting for peri-procedural hemoglobin changes, independent of blood product transfusion strategies, and assess its correlation with outcomes in patients undergoing left ventricular assist device (LVAD) implantation We included consecutive patients undergoing LVAD implantation at a single center between 10/1/2008 and 6/1/2014. The anemia stress index (ASI), defined as the sum of number of packed red blood cells transfused and the hemoglobin changes after LVAD implantation, was calculated for each patient at 24 h, discharge, and 3 months after LVAD implantation. Our cohort included 166 patients (80.1% males, mean age 56.3 ± 15.6 years) followed up for a median of 12.3 months. Increases in ASI per unit were associated with a higher hazard for all-cause mortality and early RV failure. The associations between the ASI and all-cause mortality persisted after multivariable adjustment, irrespective of when it was calculated (adjusted HR of 1.11, 95% CI 1.03–1.20 per unit increase in ASI). Similarly, ASI at 24 h after implant was associated with early RV failure despite multivariable adjustment (OR 1.09, 95% CI 1.05–1.14). We present a novel metric, the ASI, that is correlated with an increased risk for all-cause mortality and early RV failure in LVAD recipients.https://www.mdpi.com/2077-0383/11/15/4517outcomesleft ventricular assist device |
| spellingShingle | Supriya Shore Thomas C. Hanff Jeremy A. Mazurek Arieh Fox Monique S. Tanna Edward W. Grandin Robert Zhang Joyce Wald Carli Peters Michael A. Acker Pavan Atluri J. Eduardo Rame Lee R. Goldberg Mariell Jessup Kenneth B. Margulies Edo Y. Birati The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices Journal of Clinical Medicine outcomes left ventricular assist device |
| title | The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices |
| title_full | The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices |
| title_fullStr | The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices |
| title_full_unstemmed | The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices |
| title_short | The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices |
| title_sort | anemia stress index anemia transfusions and mortality in patients with continuous flow ventricular assist devices |
| topic | outcomes left ventricular assist device |
| url | https://www.mdpi.com/2077-0383/11/15/4517 |
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