Abstract 6983: Real-World Evaluation of In-Hospital Mortality and Vascular Complications in Patients Receiving Impella Support in a Community Based Health Care System

Abstract

Introduction: Impella is a peripherally inserted ventricular assist device used for hemodynamic support in patients during high risk percutaneous coronary interventions (PCI) and for management of cardiogenic shock. The aim of our study is to identify the mortality and vascular complications related to Impella placement in a real-world community health care setting. Methods: This is a retrospective observational study of patients who had Impella device implanted for high risk PCI and/or cardiogenic shock at three hospitals in the Geisinger Health Care System from January 2015-March 2020. Results: Ninety-nine patients had devices implanted during this time. One patient was excluded from analysis due to missing data. In hospital mortality rate was 31.6% for the entire group. The mortality rates varied significantly based on the acuity of procedure (p = <.001). In-hospital mortality rates for patients receiving the Impella electively, urgently, emergently, and as a salvage procedure, was 0, 17.1, 46.4 and 65% respectively. The overall rate of vascular complications was 13.1% and was not related to the acuity of procedure (p = .16). Patients with a greater body mass index (BMI) had an increased frequency of vascular complications (OR = 1.89 95%CI: 1.31, 2.47, p < .0001). Although not significantly significant, 14.7% of males had vascular complications compared to 9.7 % of females (p = .49). Conclusions: In-hospital mortality rates of patients with Impella implantation varies significantly based on the acuity of the procedure. Mortality remains high in patients with emergent & salvage procedures. 2. Patients with higher BMI develop more frequent vascular complications. 3. No statistically significant difference in gender related vascular complication rates was found.