Abstract 12609: Contemporary Trends of Outcomes in Left Ventricular Assist Device: Insight From Nationwide Readmission Database

Abstract

Hypothesis: We aimed to analyze trends of 30-day readmission and find high-risk patients associated with increased risk of mortality, resource utilization, and readmission after primary left ventricular assist device (LVAD) implantation. Introduction: Limited data exist on the contemporary trends of readmission rates and patients at a higher risk of worse outcomes post-LVAD. Methods: This is a retrospective study of adults from the NRD who received primary durable LVAD implantation from 2010-2018. The main outcomes were 30-day readmission rates and their trends in patients with primary durable LVAD implantation from 2010-2018. This study also sought to identify the patients at the highest risk for readmission, in-hospital mortality, and resource utilization. Results: A total of 31,002 adults with primary durable LVAD implantation were included in the present analysis. Overall, 3808 (12.3%) died, and 27168 (87.6%) were discharged alive. Of those discharged alive, 8303 (30.6%) patients were readmitted within 30 days. The trend of 30-day all-cause readmission among LVAD implantation patients remained similar from 2010-2018 (p=0.809). The in-hospital mortality during index hospitalization significantly decreased (p=0.014), and the mean cost of index hospitalization increased (p=0.031) during the study period. The patients with post-LVAD in-hospital cardiac, vascular, and thromboembolic complications (i.e., high-risk patients) had the highest mortality, resource utilization, and readmission rates as compared with patients without major complications. Conclusions: This study found that the readmission rates associated with LVAD implantation did not change from 2010-2018 and identified high-risk patients who may benefit from closer monitoring after primary LVAD implantation.