Assessment of Hospital Readmissions After Mechanical Circulatory Support
Cedars-Sinai Heart Institute, Los Angeles, CA.
Meeting: 2015 American Transplant Congress
Abstract number: C181
Keywords: Risk factors, Ventricular assist devices
Session Information
Session Name: Poster Session C: "Loss of Breath": VADs and Other Pre-Heart Transplant Matters
Session Type: Poster Session
Date: Monday, May 4, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
Purpose: Hospital readmission is viewed as one of the benchmarks for success following mechanical circulatory support (MCS) placement. It is not clear whether there is an increase in hospital readmission in left ventricular assist device (LVAD) patients compared to Total Artificial Heart (TAH) patients. The TAH patients now have the ability to be discharged home with the use of the new freedom driver, which is a portable console. We assessed freedom from readmission after the placement of the LVAD or the TAH. We further evaluated readmissions based on cause.
Methods: Between 2010 and 2014, we evaluated 104 patients who received an MCS device. There were 82 LVAD and 22 TAH patients. These patients were assessed for 6 month actuarial freedom from readmission and further stratified to freedom from readmission for the following causes: stroke, gastrointestinal bleed, infection, and renal dysfunction.
Results: 6 month actuarial freedom from hospital readmission was similar between the LVAD and TAH groups. In a sub-study of cause, there was no significant difference between stroke, gastrointestinal bleed, infection, and renal dysfunction readmissions (see table).
| Endpoints | LVAD (n=82) | TAH w/ Freedom Driver (n=22) | P-Value | ||
| 6-Month Actuarial Device Success | 85.6% | 100.0% | 0.187 | ||
| 6-Month Actuarial Freedom from Readmission | 53.2% | 51.8% | 0.571 | ||
| 6-Month Actuarial Freedom from Stroke Readmission | 90.9% | 100.0% | 0.218 | ||
| 6-Month Actuarial Freedom from GI Bleed Readmission | 92.4% | 73.1% | 0.105 | ||
| 6-Month Actuarial Freedom from Infection Readmission | 79.0% | 88.9% | 0.331 | ||
| 6-Month Actuarial Freedom from Renal Dysfunction | 100.0% | 100.0% | >0.999 | ||
| *Device Success defined as alive and/or bridged to transplant | |||||
Conclusion: Freedom from hospital readmissions in TAH patients with the Freedom Driver is comparable to LVAD patients.
To cite this abstract in AMA style:
Arabia F, Kittleson M, Czer L, Hajj J, Passano E, Liou F, Siddiqui S, Chang D, Kobashigawa J, Moriguchi J. Assessment of Hospital Readmissions After Mechanical Circulatory Support [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/assessment-of-hospital-readmissions-after-mechanical-circulatory-support/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress