Predictors of hospital length of stay after implantation of a left ventricular assist device: An analysis of the INTERMACS registry

William G. Cotts; Edwin C. McGee; Susan L. Myers; David C. Naftel; James B. Young; James K. Kirklin; Kathleen L. Grady

doi:10.1016/j.healun.2014.02.022

Predictors of hospital length of stay after implantation of a left ventricular assist device: An analysis of the INTERMACS registry

William G. Cotts^*, Edwin C. McGee, Susan L. Myers, David C. Naftel, James B. Young, James K. Kirklin, Kathleen L. Grady

^*Corresponding author for this work

Surgery, Cardiac Surgery Division

Research output: Contribution to journal › Article › peer-review

42 Scopus citations

Abstract

Background Few studies have reported on hospital length of stay (LOS) after left ventricular assist device (LVAD) implantation. The purpose of this study was to determine pre- and peri-operative predictors of hospital LOS after LVAD implantation. Methods We analyzed adult primary continuous-flow LVAD patients implanted between June 23, 2006 and December 31, 2010 at 105 institutions from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). Retrospective analyses included measures of central tendency, frequencies, correlations and stepwise multivariable regression modeling (p ≤0.05). Independent variables included demographic characteristics, pre-implant clinical and behavioral variables and concomitant surgery. Results Characteristics of the patients (n = 2,200) included: mean age 54.6 ± 12.6 years; 79% male; 69% white; 57% INTERMACS Profile 1 or 2; 37% diabetic; 21% with history of coronary artery bypass graft (CABG); 7% with history of valve surgery; and 37% with concomitant surgery. Median hospital LOS (implant to discharge) was 20 days. Significant predictors of an increased hospital LOS included demographic characteristics (older age and non-white), pre-implant clinical variables (history of CABG or valve surgery, diabetes, ascites, INTERMACS Profiles 1 and 2, low albumin, high blood urea nitrogen, high right atrial pressure) and concomitant surgery, explaining 12% variance (F = 22.65, p<0.001). Conclusions Demographic characteristics, pre-implant variables and concomitant surgery partially explained hospital LOS after continuous-flow LVAD implant. These variables have implications regarding selection of patients for mechanical circulatory support.

Original language	English (US)
Pages (from-to)	682-688
Number of pages	7
Journal	Journal of Heart and Lung Transplantation
Volume	33
Issue number	7
DOIs	https://doi.org/10.1016/j.healun.2014.02.022
State	Published - Jul 2014

Funding

This project has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract No. HHSN268201100025C

Keywords

continuous flow
heart failure
length of stay
mechanical circulatory support
ventricular assist device

ASJC Scopus subject areas

Surgery
Pulmonary and Respiratory Medicine
Cardiology and Cardiovascular Medicine
Transplantation

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.healun.2014.02.022

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@article{30c3e93c0fc64aeea579be6fdd5b3a91,

title = "Predictors of hospital length of stay after implantation of a left ventricular assist device: An analysis of the INTERMACS registry",

abstract = "Background Few studies have reported on hospital length of stay (LOS) after left ventricular assist device (LVAD) implantation. The purpose of this study was to determine pre- and peri-operative predictors of hospital LOS after LVAD implantation. Methods We analyzed adult primary continuous-flow LVAD patients implanted between June 23, 2006 and December 31, 2010 at 105 institutions from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). Retrospective analyses included measures of central tendency, frequencies, correlations and stepwise multivariable regression modeling (p ≤0.05). Independent variables included demographic characteristics, pre-implant clinical and behavioral variables and concomitant surgery. Results Characteristics of the patients (n = 2,200) included: mean age 54.6 ± 12.6 years; 79% male; 69% white; 57% INTERMACS Profile 1 or 2; 37% diabetic; 21% with history of coronary artery bypass graft (CABG); 7% with history of valve surgery; and 37% with concomitant surgery. Median hospital LOS (implant to discharge) was 20 days. Significant predictors of an increased hospital LOS included demographic characteristics (older age and non-white), pre-implant clinical variables (history of CABG or valve surgery, diabetes, ascites, INTERMACS Profiles 1 and 2, low albumin, high blood urea nitrogen, high right atrial pressure) and concomitant surgery, explaining 12% variance (F = 22.65, p<0.001). Conclusions Demographic characteristics, pre-implant variables and concomitant surgery partially explained hospital LOS after continuous-flow LVAD implant. These variables have implications regarding selection of patients for mechanical circulatory support.",

keywords = "continuous flow, heart failure, length of stay, mechanical circulatory support, ventricular assist device",

author = "Cotts, {William G.} and McGee, {Edwin C.} and Myers, {Susan L.} and Naftel, {David C.} and Young, {James B.} and Kirklin, {James K.} and Grady, {Kathleen L.}",

note = "Funding Information: This project has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract No. HHSN268201100025C",

year = "2014",

month = jul,

doi = "10.1016/j.healun.2014.02.022",

language = "English (US)",

volume = "33",

pages = "682--688",

journal = "Journal of Heart and Lung Transplantation",

issn = "1053-2498",

publisher = "Elsevier Inc.",

number = "7",

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TY - JOUR

T1 - Predictors of hospital length of stay after implantation of a left ventricular assist device

T2 - An analysis of the INTERMACS registry

AU - Cotts, William G.

AU - McGee, Edwin C.

AU - Myers, Susan L.

AU - Naftel, David C.

AU - Young, James B.

AU - Kirklin, James K.

AU - Grady, Kathleen L.

N1 - Funding Information: This project has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract No. HHSN268201100025C

PY - 2014/7

Y1 - 2014/7

N2 - Background Few studies have reported on hospital length of stay (LOS) after left ventricular assist device (LVAD) implantation. The purpose of this study was to determine pre- and peri-operative predictors of hospital LOS after LVAD implantation. Methods We analyzed adult primary continuous-flow LVAD patients implanted between June 23, 2006 and December 31, 2010 at 105 institutions from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). Retrospective analyses included measures of central tendency, frequencies, correlations and stepwise multivariable regression modeling (p ≤0.05). Independent variables included demographic characteristics, pre-implant clinical and behavioral variables and concomitant surgery. Results Characteristics of the patients (n = 2,200) included: mean age 54.6 ± 12.6 years; 79% male; 69% white; 57% INTERMACS Profile 1 or 2; 37% diabetic; 21% with history of coronary artery bypass graft (CABG); 7% with history of valve surgery; and 37% with concomitant surgery. Median hospital LOS (implant to discharge) was 20 days. Significant predictors of an increased hospital LOS included demographic characteristics (older age and non-white), pre-implant clinical variables (history of CABG or valve surgery, diabetes, ascites, INTERMACS Profiles 1 and 2, low albumin, high blood urea nitrogen, high right atrial pressure) and concomitant surgery, explaining 12% variance (F = 22.65, p<0.001). Conclusions Demographic characteristics, pre-implant variables and concomitant surgery partially explained hospital LOS after continuous-flow LVAD implant. These variables have implications regarding selection of patients for mechanical circulatory support.

AB - Background Few studies have reported on hospital length of stay (LOS) after left ventricular assist device (LVAD) implantation. The purpose of this study was to determine pre- and peri-operative predictors of hospital LOS after LVAD implantation. Methods We analyzed adult primary continuous-flow LVAD patients implanted between June 23, 2006 and December 31, 2010 at 105 institutions from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). Retrospective analyses included measures of central tendency, frequencies, correlations and stepwise multivariable regression modeling (p ≤0.05). Independent variables included demographic characteristics, pre-implant clinical and behavioral variables and concomitant surgery. Results Characteristics of the patients (n = 2,200) included: mean age 54.6 ± 12.6 years; 79% male; 69% white; 57% INTERMACS Profile 1 or 2; 37% diabetic; 21% with history of coronary artery bypass graft (CABG); 7% with history of valve surgery; and 37% with concomitant surgery. Median hospital LOS (implant to discharge) was 20 days. Significant predictors of an increased hospital LOS included demographic characteristics (older age and non-white), pre-implant clinical variables (history of CABG or valve surgery, diabetes, ascites, INTERMACS Profiles 1 and 2, low albumin, high blood urea nitrogen, high right atrial pressure) and concomitant surgery, explaining 12% variance (F = 22.65, p<0.001). Conclusions Demographic characteristics, pre-implant variables and concomitant surgery partially explained hospital LOS after continuous-flow LVAD implant. These variables have implications regarding selection of patients for mechanical circulatory support.

KW - continuous flow

KW - heart failure

KW - length of stay

KW - mechanical circulatory support

KW - ventricular assist device

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ER -

Predictors of hospital length of stay after implantation of a left ventricular assist device: An analysis of the INTERMACS registry

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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