Journal article
Risk Factors and Outcomes of Gastrointestinal Bleeding in Left Ventricular Assist Device Recipients
The American journal of cardiology, Vol.117(2), pp.240-244
01/15/2016
DOI: 10.1016/j.amjcard.2015.10.041
PMID: 26651456
Abstract
Increasing use of left ventricular assist devices (LVADs) has been accompanied by rising incidence of gastrointestinal bleeding (GIB). Objectives of this study were to determine the yearly incidence of GIB in LVAD recipients, compare outcomes of continuous-flow (CF) and pulsatile-flow LVAD eras, and investigate for risk factors. The Healthcare Cost and Utilization Project–Nationwide Inpatient Sample database from 2005 to 2010 was analyzed. Primary outcome of interest was incidence of GIB in LVAD recipients. Multivariate logistic regression model was used to examine independent associations of GIB with risk factors and outcomes. An estimated 8,879 LVAD index admissions and 8,722 readmissions in LVAD recipients over 6 years were analyzed. The yearly incidence of GIB after LVAD implantation increased from 5% in 2005 to 10% in 2010. On multivariate regression analysis, the odds of GIB was 3.24 times greater (95% confidence interval 1.53 to 6.89) in the era of CF LVADs than in the era of pulsatile-flow LVADs. Compared to their younger counterparts, in LVAD recipients aged >65 years, the adjusted odds of GIB was 20.5 times greater (95% confidence interval 2.24 to 188). GIB did not significantly increase the inhospital mortality but increased the inpatient length of stay. In conclusion, the incidence of GIB in LVAD recipients has increased since the use of CF LVADs has increased, leading to greater inpatient lengths of stay and hospital charges. Older recipients of CF LVADs appear to be at a greater risk of GIB.
Details
- Title: Subtitle
- Risk Factors and Outcomes of Gastrointestinal Bleeding in Left Ventricular Assist Device Recipients
- Creators
- Parijat Saurav Joy - Department of Internal Medicine, University of Iowa, Iowa City, IowaGagan Kumar - Department of Critical Care, Phoebe Putney Memorial Hospital, Albany, GeorgiaAchuta Kumar Guddati - Department of Hematology and Oncology, SUNY Downstate Medical Center, New York, New YorkJay Kumar Bhama - Department of Cardiothoracic Surgery, University of Iowa, Iowa City, IowaLinda Marie Cadaret - Department of Internal Medicine, University of Iowa, Iowa City, Iowa
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.117(2), pp.240-244
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.amjcard.2015.10.041
- PMID
- 26651456
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Language
- English
- Date published
- 01/15/2016
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094562602771
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