(714) - Comparison of 6 Month Hospitalizations in Mechanical Circulatory Support Patients vs Heart Transplant Patients

Abstract

The benefit of Mechanical Circulatory Support (MCS) versus heart transplant is an ongoing debate. Outcomes can be measured by the number of re-hospitalizations in the first 6 months after each procedure discharge. Cost and quality of life are impaired with increasing number of hospitalizations post-procedure. We sought to assess this question by evaluating our MCS and heart transplant patients for hospitalizations 6 months after the procedure discharge. Between 2010 and 2013 we evaluated 51 MCS patients and 309 heart transplant patients who had at least 6 months follow up. After the initial hospitalizations, re-hospitalization was monitored including the cause for re-hospitalization. The average number of days of re-hospitalization was measured between both groups. There were significantly more re-hospitalizations and a longer average number of hospital days in the MCS group compared to the heart transplant group (see table). The most common cause for hospitalization in the MCS group included: bleeding, infection, GI problem, hematologic, neurologic, planned procedure and heart failure. The most common causes in the heart transplant group included: infection, GI problem, arrhythmia, rejection, neurologic, heart failure, hematologic and renal dysfunction. There was no difference seen in a subgroup comparison between LVAD and TAH patients for average number of readmission days (18.3 ± 16.9 vs. 32.5 ± 30.0, P=0.306) or readmissions in the first 6-months (63.6% vs. 85.7%, P=0.250). Re-hospitalization in the first 6 months in MCS patients is more prevalent compared to heart transplant patients. MCS appears to have greater morbidity leading to re-hospitalization compared to heart transplantation.Tabled 1EndpointsMCS Patients (N=51)Heart Transplant Patients (N=309)P-ValueAny Readmission within 6-Months Post initial Discharge (%)66.7% (34/51)35.9% (111/309)<.001Total Number of Readmissions, Mean ± SD1.4 ± 1.40.6 ± 1.0<.001Average Number of Readmission Days, Mean ± SD20.8 ± 20.011.0 ± 15.50.012 Open table in a new tab