345 - Analysis of Hospitalizations and In-Hospital Mortality after Cardiac Transplantation in the United States

Abstract

Background: Roughly around two thousand cardiac transplantations are being performed every year in US. Cardiac transplant recipients (CTR) have a better survival with three year survival approaching 75%. There is limited data on the most common causes of hospitalizations and in-hospital mortality in these cardiac transplant recipients. Objective: We sought to find out the most common reasons for hospitalization and in-hospital mortality in CTR in the United States using National Inpatient Sample (NIS) from 2008 to 2014. Methods: With NIS data, we identified CTR who were hospitalized from 2008 to 2014 using International Classification of Diseases—9th edition (ICD-9) code V42.1. We then identified the most common reasons of hospitalizations and in-hospital mortality using appropriate ICD-9 codes for primary admission diagnoses. Results: Our study shows that there were 110,894 hospitalizations of CTR from 2008 to 2014. The ten most common reason for hospitalization among these patients were pneumonia (6.5%), septicemia (5%), acute renal failure (4.9%), complication of graft, implant or device (4.4%), intestinal infection (3%), complications of surgical or medical care (2.8%), fluid and electrolyte imbalance (2.5%), skin and subcutaneous tissue infection (2.4%), congestive heart failure (2.4%) and viral infections including herpes simplex, zoster, influenza etc (2.3%). A total of 2395 CTR died during hospitalization. We found that the ten most common reasons for in-hospital mortality in these patients were sepsis (26.2%), respiratory failure (7.5%), complication of graft, implant or device (5.8%), pneumonia (4.3%), acute renal failure (4.1%), acute cerebrovascular accident (3.9%), congestive heart failure (2.9%), lung cancer (2.5%), acute myocardial infarction (2.3%) and intestinal infections (2.1%). Conclusion: Infectious causes are among the most common reasons for hospitalization and in-hospital mortality in cardiac transplant recipients.Tabled 1Most common reasons for hospitalization in cardiac transplant recipients in the United StatesReason for hospitalizationPercentage of total hospitalizations of cardiac transplant recipientsPneumonia6.5%Sepsis5.0%Acute renal failure4.9%Complication of graft, implant or device4.4%Intestinal infection3.0%Complication of surgical or medical care2.8%Fluid and electrolyte imbalance2.5%Skin and subcutaneous tissue infection2.4%Congestive heart failure2.4%Viral infections2.1%Most common reasons for in-hospital mortality in cardiac transplant recipientsReasons for in-hospital mortalityPercentage of total hospitalizations of cardiac transplant recipientsSepsis26.2%Respiratory failure7.5%Complication of graft, implant or device5.8%Pneumonia4.3%Acute renal failure4.1%Acute cerebrovascular accident3.9%Congestive heart failure2.9%Lung cancer2.5%Acute myocardial infarction2.3%Intestinal infections2.1% Open table in a new tab