Literature DB >> 33058477

Gender-based outcomes of impeller pumps percutaneous ventricular assist devices.

Mohammed Osman1, Moinuddin Syed1, Yasir Abdul Ghaffar1, Brijesh Patel1, Ashraf Abugroun2, Babikir Kheiri3, Akram Kawsara1, Madhavi Kadiyala1, Sudarshan Balla1, Ramesh Daggubati1.   

Abstract

BACKGROUND: There is paucity of data focusing on females' outcomes after the use of impeller pumps percutaneous ventricular assist devices (IPVADs).
METHODS: Patients who received IPVADs during the period of October 1st, 2015-December 31, 2017, were identified from the United States National Readmission Database. A 1:1 propensity score matching was used to compare the outcomes between females and males.
RESULTS: A total of 19,278 (Female = 5,456; Male = 13,822) patients were included in the current analysis. After propensity score matching and among all-comers who were treated with IPVADs, females had higher in-hospital major adverse events (MAEs) (38 vs. 32.6%, p < .01), mortality (31 vs. 28%, p < .01), vascular complications (3.3 vs. 2.1%, p < .01), major bleeding (7.8 vs. 4.8%, p < .01), nonhome discharges (21.6 vs. 16.3%; p < .01), and longer length of stay (7 days [IQR 2-12] vs. 6 days [IQR 2-12], p = .02) with higher 30-day readmission rate compared to males (20.5 vs.16.4%, p < .01). Furthermore, among patients who received the IPVADs for high-risk percutaneous coronary intervention (HRPCI), females continued to have worse MAEs, which was driven by high rates of major bleeding. However, among patients who received IPVADs for cardiogenic shock (CS) the outcomes of females and males were comparable.
CONCLUSIONS: Among all-comers who received IPVADs, females suffered higher morbidity and mortality compared to males. Higher morbidity driven mainly by higher rates of major bleeding was seen among females who received IPVADs for the hemodynamic support during HRPCI and comparable outcomes were observed when the IPVADs were used for CS.
© 2021 Wiley Periodicals LLC.

Entities:  

Keywords:  30-day readmission; cardiogenic shock; gender disparity; high-risk percutaneous coronary intervention; in-hospital outcomes; percutaneous ventricular assist devices

Mesh:

Year:  2020        PMID: 33058477      PMCID: PMC8381270          DOI: 10.1002/ccd.29222

Source DB:  PubMed          Journal:  Catheter Cardiovasc Interv        ISSN: 1522-1946            Impact factor:   2.692


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3.  2015 SCAI/ACC/HFSA/STS Clinical Expert Consensus Statement on the Use of Percutaneous Mechanical Circulatory Support Devices in Cardiovascular Care: Endorsed by the American Heart Assocation, the Cardiological Society of India, and Sociedad Latino Americana de Cardiologia Intervencion; Affirmation of Value by the Canadian Association of Interventional Cardiology-Association Canadienne de Cardiologie d'intervention.

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Review 9.  Percutaneous short-term active mechanical support devices in cardiogenic shock: a systematic review and collaborative meta-analysis of randomized trials.

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