Abstract 11563: Frailty Predicts Hospital Outcomes in Patients With LVAD: A Nationwide Inpatient Analysis

Abstract

Introduction: Frailty is recognized as a major prognostic indicator in heart failure and is linked to perioperative morbidity and mortality. We sought to evaluate the prognostic value of frailty on hospital outcomes in patients with Left Ventricular Assist Device (LVAD) therapy. Hypothesis: Frailty portends a worse prognosis in patients with LVAD. Methods: This population-based, retrospective observational study extracted data of hospitalized adult patients with current LVAD therapy from the US Nationwide Inpatient Sample (NIS) database (2018). Participants were stratified into frail and non-frail using the Johns Hopkins (ACG) frailty-defining diagnosis indicator. Study endpoints were in-hospital mortality, sepsis, length of hospital stay, and total charges (u$$). Univariate and multivariate analyses were performed to determine associations between the endpoints and frailty. Results: A total of 23,210 weighted adult patients had the presence of LVAD therapy during index hospital admission. The mean age was 60 years old, 86% were men and a total of 13% of the patients with LVAD were considered frail. Of note, frail patients with current LVAD had an overall higher burden of comorbidities than those without frailty status. In addition, the prevalence of frailty steadily increased in groups with higher Charlson Comorbidity Index (CCI) scores (p-value <0.001). Hospital outcomes including mortality, sepsis, and LOS were higher among the frail populations as well as hospital costs (Table 1). Finally, after multivariate analysis for clinical variables, frailty at admission had a nearly 2-fold increase in mortality (OR 1.67, CI 95% 1.19-2.34, p-value 0.002). Conclusions: Frailty is a prevalent condition among patients with current LVAD therapy and portends a worse prognosis as well as higher hospital costs. Table 1. In-Hospital outcomes