The Impact of Left Ventricular Assist Device Infections on Clinical Outcomes

Abstract

<h3>Purpose</h3> Infection is a leading cause of morbidity for patients with left ventricular assist devices (LVAD). We assessed the risks and associated mortality of LVAD infections. <h3>Methods</h3> A single center, retrospective study of patients with durable LVADs was performed. Patient demographics, clinical characteristics, and outcomes were evaluated and LVAD infections classified per ISHLT 2011 guidelines. <h3>Results</h3> Of 241 LVAD implants between January 2007 and December 2020, 134 (56%) had documented infection; 56 (42%) LVAD specific, 47 (35%) LVAD related, and 31 (23%) non-LVAD infections (Table). Body mass index (BMI), age, and history of chronic kidney disease (CKD) or diabetes (DM) were similar among the different infection groups. In univariate analyses, receiving antibiotics for infection at the time of LVAD placement, duration of index hospitalization, and duration of LVAD support differed significantly among those with and without infection. In multivariable analysis, only length of index hospitalization increased the risk of developing LVAD specific or related infections (p<0.001). Mortality at 3 years was 28% for those with LVAD specific infections, 42% for LVAD related, 45% for non-LVAD, and 39% for those without infection (p = 0.533). When adjusting for age, BMI, CKD, DM, length of index hospitalization, and duration of LVAD support, there was no difference in mortality at 3 years among the different infection groups (Figure). <h3>Conclusion</h3> Infection is a frequent complication for LVAD patients and a continuing problem despite advances in devices. However, having an infection was not independently associated with increased 3-year mortality in our cohort.