Risk factor analysis of Swedish left ventricular assist device (LVAD) patients
(2003) In Annals of Thoracic Surgery 76(6). p.1993-1998- Abstract
- Background. The use of left ventricular assist devices (LVADs) is established as a bridge to heart transplantation. Methods. All Swedish patients on the waiting list for heart transplantation, treated with LVAD since 1993 were retrospectively collected into a database and analyzed in regards to risk factors for mortality and morbidity. Results. Fifty-nine patients (46 men) with a median age of 49 years (range, 14 to 69 years), Higgins score median of 9 (range, 3 to 15), EuroScore median of 10 (range, 5 to 17) were investigated. Dominating diagnoses were dilated cardiomyopathy in 61% (n = 36) and ischemic cardiomyopathy in 18.6% (n = 11). The patients were supported with LVAD for a median time of 99.5 days (range, I to 873 days). Forty-five... (More)
- Background. The use of left ventricular assist devices (LVADs) is established as a bridge to heart transplantation. Methods. All Swedish patients on the waiting list for heart transplantation, treated with LVAD since 1993 were retrospectively collected into a database and analyzed in regards to risk factors for mortality and morbidity. Results. Fifty-nine patients (46 men) with a median age of 49 years (range, 14 to 69 years), Higgins score median of 9 (range, 3 to 15), EuroScore median of 10 (range, 5 to 17) were investigated. Dominating diagnoses were dilated cardiomyopathy in 61% (n = 36) and ischemic cardiomyopathy in 18.6% (n = 11). The patients were supported with LVAD for a median time of 99.5 days (range, I to 873 days). Forty-five (76%) patients received transplants, and 3 (5.1%) patients were weaned from the device. Eleven patients (18.6%) died during LVAD treatment. Risk factor analysis for mortality before heart transplantation showed significance for a high total amount of autologous blood transfusions (p < 0.001), days on mechanical ventilation postoperatively (p < 0.001), prolonged postoperative intensive care unit stay (p = 0.007), and high central venous pressure 24 hours postoperatively and at the final measurement (p = 0.03 and 0.01, respectively). Mortality with LVAD treatment was 18.6% (n = 11). High C-reactive protein (p = 0.001), low mean arterial pressure (p = 0.03), and high cardiac index (p = 0.03) preoperatively were risk factors for development of right ventricular failure during LVAD treatment. Conclusions. The Swedish experience with LVAD as a bridge to heart transplantation was retrospectively collected into a database. This included data from transplant and nontransplant centers. Figures of mortality and morbidity in the database were comparable to international experience. Specific risk factors were difficult to define retrospectively as a result of different protocols for follow-up among participating centers. (C) 2003 by The Society of Thoracic Surgeons. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/293978
- author
- Granfeldt, H ; Koul, Bansi LU ; Wiklund, L ; Peterzen, B ; Lonn, U ; Babic, A and Ahn, HC
- organization
- publishing date
- 2003
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of Thoracic Surgery
- volume
- 76
- issue
- 6
- pages
- 1993 - 1998
- publisher
- Elsevier
- external identifiers
-
- wos:000186986500046
- pmid:14667628
- scopus:0345527904
- ISSN
- 1552-6259
- DOI
- 10.1016/S0003-4975(03)01016-6
- language
- English
- LU publication?
- yes
- id
- 1b74333a-16ce-4f08-adff-c8f2a97e1913 (old id 293978)
- alternative location
- http://ats.ctsnetjournals.org/cgi/content/abstract/76/6/1993
- date added to LUP
- 2016-04-01 11:51:57
- date last changed
- 2022-01-26 19:26:01
@article{1b74333a-16ce-4f08-adff-c8f2a97e1913, abstract = {{Background. The use of left ventricular assist devices (LVADs) is established as a bridge to heart transplantation. Methods. All Swedish patients on the waiting list for heart transplantation, treated with LVAD since 1993 were retrospectively collected into a database and analyzed in regards to risk factors for mortality and morbidity. Results. Fifty-nine patients (46 men) with a median age of 49 years (range, 14 to 69 years), Higgins score median of 9 (range, 3 to 15), EuroScore median of 10 (range, 5 to 17) were investigated. Dominating diagnoses were dilated cardiomyopathy in 61% (n = 36) and ischemic cardiomyopathy in 18.6% (n = 11). The patients were supported with LVAD for a median time of 99.5 days (range, I to 873 days). Forty-five (76%) patients received transplants, and 3 (5.1%) patients were weaned from the device. Eleven patients (18.6%) died during LVAD treatment. Risk factor analysis for mortality before heart transplantation showed significance for a high total amount of autologous blood transfusions (p < 0.001), days on mechanical ventilation postoperatively (p < 0.001), prolonged postoperative intensive care unit stay (p = 0.007), and high central venous pressure 24 hours postoperatively and at the final measurement (p = 0.03 and 0.01, respectively). Mortality with LVAD treatment was 18.6% (n = 11). High C-reactive protein (p = 0.001), low mean arterial pressure (p = 0.03), and high cardiac index (p = 0.03) preoperatively were risk factors for development of right ventricular failure during LVAD treatment. Conclusions. The Swedish experience with LVAD as a bridge to heart transplantation was retrospectively collected into a database. This included data from transplant and nontransplant centers. Figures of mortality and morbidity in the database were comparable to international experience. Specific risk factors were difficult to define retrospectively as a result of different protocols for follow-up among participating centers. (C) 2003 by The Society of Thoracic Surgeons.}}, author = {{Granfeldt, H and Koul, Bansi and Wiklund, L and Peterzen, B and Lonn, U and Babic, A and Ahn, HC}}, issn = {{1552-6259}}, language = {{eng}}, number = {{6}}, pages = {{1993--1998}}, publisher = {{Elsevier}}, series = {{Annals of Thoracic Surgery}}, title = {{Risk factor analysis of Swedish left ventricular assist device (LVAD) patients}}, url = {{http://dx.doi.org/10.1016/S0003-4975(03)01016-6}}, doi = {{10.1016/S0003-4975(03)01016-6}}, volume = {{76}}, year = {{2003}}, }