The analysis of unplanned readmissions after left ventricular assist device implantation as bridge-to-transplant.

Autor:	Sezgin M; Department of Cardiovascular Surgery, Tunceli State Hospital, Tunceli, Turkey., Rabuş MB; Department of Cardiovascular Surgery, Istanbul Kartal Koşuyolu Yüksek Ihtisas Training and Research Hospital, Istanbul, Turkey., Selçuk E; Department of Cardiovascular Surgery, Muş State Hospital, Muş, Turkey., Altaş Ö; Department of Cardiovascular Surgery, Istanbul Kartal Koşuyolu Yüksek Ihtisas Training and Research Hospital, Istanbul, Turkey., Sarıkaya S; Department of Cardiovascular Surgery, Istanbul Kartal Koşuyolu Yüksek Ihtisas Training and Research Hospital, Istanbul, Turkey., Balkanay M; Department of Cardiovascular Surgery, Yeni Yüzyıl University Medical Faculty, Istanbul, Turkey., Kırali MK; Department of Cardiovascular Surgery, Istanbul Kartal Koşuyolu Yüksek Ihtisas Training and Research Hospital, Istanbul, Turkey.
Jazyk:	angličtina
Zdroj:	Turk gogus kalp damar cerrahisi dergisi [Turk Gogus Kalp Damar Cerrahisi Derg] 2020 Jan 23; Vol. 28 (1), pp. 55-62. Date of Electronic Publication: 2020 Jan 23 (Print Publication: 2020).
DOI:	10.5606/tgkdc.dergisi.2020.18836
Abstrakt:	Background: In this study, we aimed to investigate frequency, patterns, etiologies, and costs of unplanned readmissions after left ventricular assist device implantation. Methods: Between April 2012 and September 2016, 99 unplanned readmissions of a total of 50 consecutive bridge-to-transplant patients (45 males, 5 females; mean age 46.9±10.3 years; range, 19 to 67 years) who were successfully discharged after left ventricular assist device implantation were retrospectively analyzed. Patient demographic data, hemodynamic measurements before implantation, and readmissions after discharge were recorded. Hospitalizations due to major problems which were unable to be managed in routine outpatient clinic were accepted as unplanned readmissions. Survival analysis was performed. Results: The readmission rate was 1.7 per year after discharge. Survival of patients who were readmitted within the first 90 days was found to be significantly lower than those without early readmission. The most common reasons of readmissions during follow-up were major infection (23.2%), neurological dysfunction (22.2%), cardiac causes (12.1%), bleeding (11.1%), and device malfunction (10.1%). Neurological dysfunctions (82,005 USD) and device malfunctions (73,300 USD) caused the highest economic burden. Conclusion: Among patients with a left ventricular assist device, hospital readmissions are common. Development of preventive strategies as well as effective treatment methods focused on longterm adverse events is critical to reduce the frequency and costs of hospital readmissions. Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article. (Copyright © 2020, Turkish Society of Cardiovascular Surgery.)
Databáze:	MEDLINE
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