Can Household Income Predict Postoperative Outcomes After LVAD Implantation?

Abstract

<h3>Purpose</h3> Over the last few decades, mechanical circulatory support therapies have become the standard of care for advanced heart failure. However, minimal data exists regarding the association of household income with postoperative outcomes after LVAD implantation. <h3>Methods</h3> We evaluated 169 patients that underwent an LVAD implantation between January 2018 to December 2020. The median income for the cohort was calculated and the patients were divided into two groups: low income (<50th percentile) and high income (≥50th percentile). Baseline demographics and clinical characteristics were summarized using descriptive statistics. A significance level of 0.05 was used. <h3>Results</h3> The low-income group represented 49% and the high-income group corresponded to 51% of the entire cohort. The median yearly income for the cohort was 19800 USD. The low-income group was found to be younger (mean age 49 ±13 vs. 54 ±12 years) (p=0.754) had less dyslipidemia (44% vs. 56%) (p=0.091) and had less preoperative stroke (8% vs. 23%) (p=0.012). The high-income group had less reoperations for bleeding (18% vs. 33%) (p=0.035) had higher rates of postoperative stroke (7.1% vs. 3.6%) (p=0.306), and higher rehospitalization rates (46% vs. 52%) (<i>p</i>=0.141). Thirteen percent (n=15) and eight percent (n=9.5) of the high-income and low-income groups had a heart transplant by the end of the study (<i>p</i>=0.095). The mortality rate was about the same for both groups (table 1). <h3>Conclusion</h3> Despite both groups being similar, the high-income group had less mortality and a higher rate of transplanted patients. Household Income may be an important variable that could affect the results after LVAD placement.