CARC16: Incidence and Costs of LVAD-associated Gastrointestinal Bleeding in Germany

Abstract

Background: Gastrointestinal bleeding (GIB) includes a common complication after left ventricular assist device (LVAD) implantation. Frequency and costs of hospitalizations of LVAD patients due to GIB are, however, unknown. Methods: Our study is based on information from the Research Data Center of the Federal Bureau of Statistics (DESTATIS). It includes data on all hospitalizations in Germany starting in 2005, including diagnoses and procedures. We analyzed administrative data from all patients with LVAD who were admitted to the hospital with GIB as main diagnosis between 2007 and 2020 in Germany. Results: A total of 1650 hospitalizations occurred in the investigated time period. The number of hospitalizations of LVAD patients due to GIB per year increased continuously (Fig). The average costs and length of hospital stay per admission were 5926±15048€ and 12.1±16.0 days, respectively, with a mortality of 1.8%. In 30.7% a transfusion of more than five red blood cell concentrates was required. Conclusion: The overall number of patients with LVAD admitted to the hospital due to GIB is relatively small, but continues to increase. The costs per admission vary significantly, yet the overall financial burden appears to be moderate. Improvement of device technology and anticoagulation strategies could further reduce the occurrence and severity of GIB complications in LVAD patients.