Abstract 12718: Ethnic Disparities in Outcomes After Left Ventricular Assist Device Implantation: An Analysis of National Inpatient Sample

Abstract

Introduction: Previous studies of patients undergoing various cardiac surgeries demonstrated worse outcomes among African American (AA) patients. It remains unclear if race is a predictor of outcomes among Left Ventricular Assist Device (LVAD) recipients. Methods: Patients who underwent LVAD implantation between 2010 and 2017 were identified using the national inpatient sample (NIS). Race was classified as Caucasians vs. AA vs. Hispanics, and endpoints were in-hospital outcomes, length of stay and cost. Procedure-related complications were identified via ICD-9 and ICD-10 coding and analysis was performed via mixed effect models. Results: A total of 27,132 adults (5,114 unweighted) underwent LVAD implantation in the U.S. between 2010 and 2017, including Caucasians (63.8%), AA (23.8%) and Hispanics (6%). The number of LVAD implantations increased in both Caucasians and AA during the study period. AA LVAD recipients were younger, with higher rates of females and most of the comorbidities, but lower rates of coronary artery disease and coronary artery bypass grafting compared to Caucasians and Hispanics. Medicaid and median income at the lowest quartile were more frequent among AA LVAD recipients. We did not identify differences in in-hospital mortality, stroke, bleeding complications, infectious complications, and acute kidney injury requiring hemodialysis among racial groups (Table). AA LVAD recipients had lower rates of routine discharge than Caucasians and Hispanics, longer length of stay than Caucasians but similar cost of hospitalization. After adjustment with age gender and clinical comorbidities, race was not a predictor of in-hospital mortality. Conclusions: We identified differences in clinical characteristics but not in in-hospital complications among LVAD recipients of different race.