The Predictive Value of Changes in Body Mass Index for the Incidence of Device-Specific Infections in Patients With Implantable Left Ventricular Assist Devices
| Autor: | Seiko Nakajima, Yoichi Iwasaki, Tomoyuki Fujita, Toshihiro Muramatsu, N. Fukushima, Hiroki Mochizuki, Kensuke Kuroda, Nobuichiro Yagi, Eiji Anegawa, Shintaro Nakano, Shigeyuki Nishimura, Koichi Yoshitake, Takuya Watanabe, Satsuki Fukushima, Shotaro Komeyama, Masanobu Yanase, Osamu Seguchi, Yasumori Sujino |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis 030204 cardiovascular system & hematology Body Mass Index 03 medical and health sciences 0302 clinical medicine Quality of life Internal medicine medicine Humans In patient Retrospective Studies Receiver operating characteristic business.industry Incidence Incidence (epidemiology) Albumin General Medicine equipment and supplies medicine.disease 030228 respiratory system Heart failure Quality of Life Cardiology Heart-Assist Devices Cardiology and Cardiovascular Medicine business Body mass index |
| Zdroj: | Circulation Journal. 85:1460-1468 |
| ISSN: | 1347-4820 1346-9843 |
| DOI: | 10.1253/circj.cj-20-1197 |
| Popis: | Background Implantable left ventricular assist devices (LVAD) have improved quality of life and survival in patients with advanced heart failure. However, LVAD-specific infections and predicting which patients will develop infections remain challenging. This study investigated whether changes in body mass index (BMI) during hospitalization following LVAD implantation are associated with LVAD-specific infections within 1 year of implantation.Methods and Results:Patients (n=135) undergoing LVAD implantation were retrospectively divided into 2 groups based on changes in BMI from LVAD implantation to discharge: those with and without decreases in BMI. Each group was further subdivided according to baseline albumin concentrations (high [>3.7 g/dL] and low [≤3.7 g/dL]). Twenty patients developed LVAD-specific infections within 1 year. Receiver operating characteristic curve analysis resulted in a ∆BMI cut-off of less than -0.128 kg/m2. In multivariate analysis, younger patients and those with decreases in BMI had significantly higher rates of LVAD-specific infection (P=0.010 and P=0.035, respectively). LVAD-specific infection rates were significantly higher for patients with low albumin and decreases in BMI than for patients with low albumin but no decrease in BMI. Conclusions Decreases in BMI during hospitalization after LVAD implantation and younger age were independently associated with LVAD-specific infection within 1 year. Strict patient management may be needed to avoid decreases in BMI during hospitalization after LVAD implantation, particularly in patients with low baseline albumin concentrations. |
| Databáze: | OpenAIRE |
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