Abstract
Introduction: Women make up approximately 50% of the patients living with heart failure but remain underrepresented in clinical trials and advanced heart failure therapies. This disparity exists among the durable left ventricular assist device (LVAD) recipients, with men receiving more LVADs than women but whether this gap is due to differences in outcomes or not, remain unresolved. Our aim was to study the in-hospital outcomes of LVAD recipients and compare them between the male and female groups. 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, males and females. 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 7,185 patients underwent LVAD implantation between 2015-2018 out of which only 1,515 (21.09%) patients were female. Baseline characteristics are compared in table 1. The in-hospital mortality was numerically higher in females as compared to males but was not statistically significant (8.91% vs 7.94%, p=0.57). Similarly, both groups had similar length of stay (38.26 ±2.16 days vs a 34.09±0.80 days, p=0.06) and cost of stay ($918,047.7±446,613.2 vs $947,554.7±29686.7, p=0.54). After multivariable analysis, female sex was not predictive of inpatient mortality (OR: 1.26, 95% CI (0.70-2.24), p=0.43). The bleeding, infectious and thromboembolic outcomes (Table 2) were similar between males and females. Conclusions: Females continue to be underrepresented among the patients receiving LVAD despite having similar outcomes and complication rate after implantation. This suggests underutilization of life saving therapy among the female patients and the need for efforts to close this gender gap.
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