Does Educational Level and Insurance Impact Mid-Term Survival after Left Ventricular Assist Device Implantation?

Abstract

Purpose Patient selection is a key determinant of outcomes after left ventricular assist device (LVAD) implantation. Educational level and insurance aspects may frequently influence the decision to implant LVAD. We evaluated the impact of insurance and education level on outcomes post-LVAD implantation. Methods and Materials Cardiac Surgery database from a single center was retrospectively reviewed for LVADs implanted between 2008 and 2011. Demographics (age, gender, insurance, race etc.) and perioperative clinical information were obtained from same database as well as hospital medical records. Univariate statistics and Kaplan-Meier curves were used to analyze impact of education level and type of insurance on early post-operative outcomes and mid-term survival. Results Of 119 patients (55.1 + 12.7 years, 86 males) enrolled during the time period, 41 (34.5%) had commercial insurance, 65 (56.6%) Medicare and 8 (6.7%) had Medicaid. Of all, 56 (47.5%) were high school graduates, 21 (17.8%) were college graduates and 41 (34.7%) had less than high school/no education. Education level and type of insurance was not significantly different in patients having post-operative complications of driveline infection, bleeding and readmissions (p-values>0.05). Mid-term survival stratified by education level and type of insurance ( figure 1 ) was comparable (p>0.05). Conclusions Education level and type of insurance in LVAD patients were not predictors of early adverse post-operative outcomes and overall mid-term survival. Therefore, education level and type insurance should not be contraindications for referral or decision to proceed for LVAD implantation.