Trends and Outcomes of Mechanical Circulatory Support in Peripartum Women, 2002-2014: A Nationwide Inpatient Sample Analysis
Autor: | Avery Tung, Sajid Shahul, Atul Gupta, Ariel Mueller, Jennifer M. Banayan, Elizabeth K. Cotter |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Population Psychological intervention 030204 cardiovascular system & hematology behavioral disciplines and activities 03 medical and health sciences 0302 clinical medicine 030202 anesthesiology Peripartum Period medicine Humans education Retrospective Studies Inpatients education.field_of_study Pregnancy Intra-Aortic Balloon Pumping business.industry Odds ratio medicine.disease United States humanities Confidence interval Treatment Outcome Anesthesiology and Pain Medicine Emergency medicine Female Heart-Assist Devices Cardiology and Cardiovascular Medicine business Postpartum period Cohort study |
Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 34:1198-1203 |
ISSN: | 1053-0770 |
DOI: | 10.1053/j.jvca.2019.11.047 |
Popis: | Objectives To systematically explore the relationship among the use of mechanical circulatory support (MCS), the timing of placement, and outcomes in pregnancy. Design Using the National Inpatient Sample and National Readmissions Database, the authors performed a retrospective, cohort analysis of peripartum women who received MCS. Setting United States hospitals. Participants A weighted sample of women who received MCS during the antepartum, delivery, or postpartum period between 2002 and 2014. Interventions MCS Measurements and Main Results There were 1,386 women who received MCS during their admission. These women were older and had more comorbidities than women without MCS. The mean time from admission to device placement was 5.4 days for all women, and MCS use was highest in urban teaching hospitals. Overall, peripartum use of MCS has increased since 2002, but mortality did not change during the same period. After adjusting for potential confounders, the odds ratio for mortality when MCS was placed within 6 days of admission was 0.48 (95% confidence interval 0.23-0.98) with the adjusted probability of death rising from 18.6% to 32.5% when the device was placed on or after day 6. Conclusions Similar to trends in the general population, use of MCS has increased in the peripartum period. Women receiving MCS were generally older and had more comorbidities than those not receiving MCS. Increased time to device placement may worsen mortality. Further research will help identify appropriate candidates and factors that improve survival. |
Databáze: | OpenAIRE |
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