Predictors and impact of right heart failure severity following left ventricular assist device implantation
| Autor: | Sasha Still, Brian Lima, Kristen M. Tecson, Joost Felius, Shelley A. Hall, Ronald D. Baxter, Susan M. Joseph, J. Collier |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Framingham Risk Score medicine.diagnostic_test business.industry medicine.medical_treatment Area under the curve 030204 cardiovascular system & hematology Hematocrit Logistic regression medicine.disease law.invention 03 medical and health sciences 0302 clinical medicine law Ventricular assist device Internal medicine Heart failure Circulatory system medicine Cardiopulmonary bypass Cardiology Original Article 030212 general & internal medicine business |
| Zdroj: | Journal of Thoracic Disease. 11:S864-S870 |
| ISSN: | 2077-6624 2072-1439 |
| DOI: | 10.21037/jtd.2018.09.155 |
| Popis: | BACKGROUND: Right heart failure (RHF) is a well-known consequence of left ventricular assist device (LVAD) placement, and has been linked to negative surgical outcomes. However, little is known regarding risk factors associated with RHF. This article delineates pre- and intra-operative risk factors for RHF following LVAD implantation and demonstrates the effect of RHF severity on key surgical outcomes. METHODS: We performed a retrospective analysis of consecutive LVAD patients treated at our center between 2008 and 2016. RHF was categorized using the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) definition of none/mild, moderate, severe, and acute-severe. We constructed a predictive model using multivariable logistic regression and performed a competing risks analysis for survival stratified by RHF severity. RESULTS: Of 202 subjects, 52 (25.7%) developed moderate or worse RHF. Cardiopulmonary bypass (CPB) time and nadir hematocrit contributed jointly to the model of RHF severity (moderate or worse vs. none/mild; area under the curve =0.77). Postoperative length of stay (LOS) was shortest in the non/mild group and longest in the acute-severe group (median 13 vs. 29.5 days; P |
| Databáze: | OpenAIRE |
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