Abstract 11740: Outcomes of Durable Left Ventricular Assist Device Implantation in Patients With End Stage Renal Diseases- Latest Outcomes From Nationwide Inpatient Sample (2015-2018)

Abstract

Introduction: Left ventricular assist devices (LVAD) improve survival in patients with advanced heart failure however their use in patients with concomitant end stage renal disease (ESRD) is limited. Previous studies demonstrate higher mortality and morbidity in this subset of patients. Our aim was to assess in-hospital outcomes in patients who undergo LVAD implantation with and without ESRD in a national cohort. Methods: Using Nationwide Inpatient Sample (NIS) for years 2015-2018, all patients who underwent LVAD implantation during the hospitalization were identified. Cohort was divided into two groups, with and without ESRD. Baseline characteristics, comorbidities, in-hospital outcomes were compared between both the groups. Statistical significance was assigned at p<0.05. Analysis was performed using STATA. Results: A total of 7185 patients underwent LVAD implantation between 2015-2018. 150 patients (2.09%) had ESRD at baseline. Despite having similar baseline characteristics and comorbidities in both groups (Table 1), the in-hospital mortality was significantly higher in patients with ESRD (43.33% vs 7.46% p-value: 0.001). Similarly, patients in ESRD group had longer length of stay (92.56 ±11.6 days vs a 33.72±0.73 days, p=0.001) and their cost of stay was also significantly higher ($2,179,827 vs $915,699, p=0.001). After multivariable analysis, ESRD remained an independent predictor of inpatient mortality (OR: 3.68, 95% CI (1.06-12.6), p=0.03). The bleeding, infectious and thromboembolic outcomes (Table 2) were also significantly higher in patients with ESRD undergoing LVAD implantation. Conclusions: Patients who are ESRD and receive LVAD during their admission are at higher risk of mortality, bleeding, infectious and thromboembolic events. More studies are required to improve management strategies and identify specific subgroup of patients who would benefit from LVAD implantation in this subset.