Association of cigarette smoking and adverse events in left ventricular assist device patients
| Autor: | Mickyas H. Eskender, Ramael Ohiomoba, Allen S. Anderson, Ashley Ezema, Jonathan D. Rich, Kambiz Ghafourian, Ike S. Okwuosa, Esther E. Vorovich, Clyde W. Yancy, Duc Thinh Pham, Amy Zhou, Rebecca Harap, Jane E. Wilcox, Quentin R. Youmans |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Prosthesis-Related Infections medicine.medical_treatment Biomedical Engineering Medicine (miscellaneous) Bioengineering 030204 cardiovascular system & hematology Cigarette Smoking Biomaterials 03 medical and health sciences 0302 clinical medicine Cigarette smoking Internal medicine medicine Humans 030212 general & internal medicine Adverse effect Proportional Hazards Models Retrospective Studies Heart Failure business.industry Incidence Thrombosis General Medicine Middle Aged Survival Analysis Ventricular assist device Cardiology Equipment Failure Female Heart-Assist Devices business |
| Zdroj: | The International journal of artificial organs. 44(3) |
| ISSN: | 1724-6040 |
| Popis: | Introduction: Adverse events (AEs) associated with left ventricular assist devices (LVADs) cause significant morbidity and mortality. Little is known about patient-specific factors that contribute to rates of AEs. The purpose of this study was to assess the association of cigarette smoking history and AEs following LVAD implantation. Methods: This study was a single-center, observational examination of 355 consecutive patients who underwent continuous-flow LVAD implantation from May 1, 2008 to July 1, 2018. Based on self-report, 348 patients with available data were categorized as never, former, or current smokers. Pre-LVAD implantation baseline characteristics were obtained, and summary characteristics were calculated. Hospitalizations for gastrointestinal bleeds, driveline infections, strokes, pump thromboses, and acute heart failure were evaluated. The Cox proportional hazard model was used to estimate the association of smoking and AE-related hospital admissions. The cumulative incidence competing risk method was used for survival analysis. Results: Current (8.22%, p 0.006) and former (4.75%, p 0.026) smokers had a greater proportion of admissions for pump thrombosis compared to never smokers (2.22%). Former smoking was associated with admission for driveline infection (HR 2.43, CI 1.08–5.46, p 0.03) on multivariate analysis. There were no significant associations between smoking and the other AEs of interest. There was no difference in survival among the three groups. Conclusions: Smokers had a higher proportion of admissions for pump thrombosis compared to never smokers, and former smoking was associated with admission for driveline infections in patients with LVADs. |
| Databáze: | OpenAIRE |
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