Complications of LVAD utilization in older adults.
Advanced Heart Failure
Delirium
Left Ventricular Assist Device
Mechanical Support Device
Older Adults
Journal
Heart & lung : the journal of critical care
ISSN: 1527-3288
Titre abrégé: Heart Lung
Pays: United States
ID NLM: 0330057
Informations de publication
Date de publication:
Historique:
received:
01
05
2020
revised:
08
07
2020
accepted:
13
07
2020
pubmed:
28
7
2020
medline:
22
4
2021
entrez:
26
7
2020
Statut:
ppublish
Résumé
Yearly rate and mean patient age of left ventricular assist device (LVAD) implantation increased from 2009 to 2014. Data are lacking regarding trends of LVAD implantation in older adults. To describe the trends of LVAD implantation in older adults and the clinical impact of associated procedural complications. We retrospectively analyzed the National Inpatient Sample from 2005 to 2014, calculated the percentage of older adults (>65 years of age) among those who underwent LVAD implantation, and compared their clinical characteristics. Primary outcomes were in-hospital mortality and discharge home. In total, 4491 patients were included. The percentage of older adults among those receiving LVAD increased from 12.53% to 31.65% (p<0.01). Older adults were more likely to develop postoperative delirium (17.90% vs. 11.92% in younger patients; p<0.01), which portended lesser odds of discharge home. Delirium develops with greater incidence in older adults undergoing LVAD implantation, which decreases odds of favorable discharge disposition.
Sections du résumé
BACKGROUND
Yearly rate and mean patient age of left ventricular assist device (LVAD) implantation increased from 2009 to 2014. Data are lacking regarding trends of LVAD implantation in older adults.
OBJECTIVES
To describe the trends of LVAD implantation in older adults and the clinical impact of associated procedural complications.
METHODS
We retrospectively analyzed the National Inpatient Sample from 2005 to 2014, calculated the percentage of older adults (>65 years of age) among those who underwent LVAD implantation, and compared their clinical characteristics. Primary outcomes were in-hospital mortality and discharge home.
RESULTS
In total, 4491 patients were included. The percentage of older adults among those receiving LVAD increased from 12.53% to 31.65% (p<0.01). Older adults were more likely to develop postoperative delirium (17.90% vs. 11.92% in younger patients; p<0.01), which portended lesser odds of discharge home.
CONCLUSIONS
Delirium develops with greater incidence in older adults undergoing LVAD implantation, which decreases odds of favorable discharge disposition.
Identifiants
pubmed: 32709497
pii: S0147-9563(20)30306-X
doi: 10.1016/j.hrtlng.2020.07.009
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
75-79Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest BA, SK, SN, IAS, BK, and IDG all report receiving in-kind support from medical companies for travel and lodging, food and beverage, and education. All transactions are reported on the OpenPayments website in accordance with the Sunshine Act, and none rise to the level of a conflict of interest.