Kirolos Barssoum1, Harsh Patel2, Devesh Rai3, Ashish Kumar4, Mohab Hassib5, Hasan F Othman6, Samarthkumar Thakkar3, Ahmed El Karyoni7, Osarenren Idemudia8, Fadi Ibrahim9, Tala Salem8, Mariam Shariff10, Ahmad Jabri11, Ayman ElBadawi12, Soidjon Khodjaev13, Dhrubajyoti Bandyopadhyay14, Wilbert S Aronow14, Vishal Parikh13, Mohan Rao15, Park Soon13. 1. Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA; Department of Internal Medicine, Unity Hospital, Rochester Regional Health System, Rochester, NY, USA. Electronic address: kiro11090@hotmail.com. 2. Department of Internal Medicine, Louis A Weiss Memorial Hospital, Chicago, IL, USA. 3. Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA. 4. Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA. 5. St. Francis Medical Center, Trenton, NJ, USA. 6. Michigan State University/Sparrow Health System, Lansing, MI, USA. 7. Cardiovascular Department, Loyola University Medical Center, IL, USA. 8. Department of Internal Medicine, Unity Hospital, Rochester Regional Health System, Rochester, NY, USA. 9. American University of Antigua, Antigua and Barbuda. 10. Department of General Surgery, Mayo Clinic, Rochester, MN, USA. 11. Heart and Vascular Center, Case Western Reserve University/MetroHealth Medical Center, Cleveland, OH, USA. 12. Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, USA; Department of Cardiovascular Medicine, Ain Shams University, Cairo, Egypt. 13. Department of Advanced Heart Failure and Transplant, Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA. 14. Department of Cardiology, New York Medical College at Westchester Medical Center, New York, NY, USA. 15. Department of Cardiology, Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA.
Abstract
BACKGROUND: Outcomes of patients with implanted left ventricular assist device (LVAD) implantation experiencing a cardiac arrest (CA) are not well reported. We aimed at defining the in-hospital outcomes of patients with implanted LVAD experiencing a CA. METHODS: The national inpatient sample (NIS) was queried using ICD9/ICD10 codes for patients older than 18 years with implanted LVAD and CA between 2010-2018. We excluded patients with orthotropic heart transplantation, biventricular assist device (BiVAD) implantation and do not resuscitate (DNR) status. RESULTS: A total of 93,153 hospitalisations between 2010 and 2018 with implanted LVAD were identified. Only 578 of these hospitalisations had experienced CA and of those, 173 (33%) hospitalisations underwent cardiopulmonary resuscitation (CPR). The mean age of hospitalisations that experienced a CA was 60.61±14.85 for non-survivors and 56.23±17.33 for survivors (p=0.14). The in-hospital mortality was 60.8% in hospitalisations with CA and 74.33% in hospitalisations in whom CPR was performed. In an analysis comparing survivors with non-survivors, non-survivors had more diabetes mellitus (DM) (p=0.01), and ischaemic heart disease (IHD) (p=0.04). Age, female sex, peripheral vascular disease and history of coronary artery bypass graft (CABG) were independently associated with increased mortality in our cohort. Also, ventricular tachycardia (VT) and CPR were independently associated with in-hospital mortality. During the study period, there was a significantly decreasing trend in performing CPR in LVAD hospitalisations with CA. CONCLUSION: In conclusion, age, female sex, peripheral vascular disease, history of CABG, VT and CPR were independently associated with in-hospital mortality in LVAD hospitalisations who experienced CA.
BACKGROUND: Outcomes of patients with implanted left ventricular assist device (LVAD) implantation experiencing a cardiac arrest (CA) are not well reported. We aimed at defining the in-hospital outcomes of patients with implanted LVAD experiencing a CA. METHODS: The national inpatient sample (NIS) was queried using ICD9/ICD10 codes for patients older than 18 years with implanted LVAD and CA between 2010-2018. We excluded patients with orthotropic heart transplantation, biventricular assist device (BiVAD) implantation and do not resuscitate (DNR) status. RESULTS: A total of 93,153 hospitalisations between 2010 and 2018 with implanted LVAD were identified. Only 578 of these hospitalisations had experienced CA and of those, 173 (33%) hospitalisations underwent cardiopulmonary resuscitation (CPR). The mean age of hospitalisations that experienced a CA was 60.61±14.85 for non-survivors and 56.23±17.33 for survivors (p=0.14). The in-hospital mortality was 60.8% in hospitalisations with CA and 74.33% in hospitalisations in whom CPR was performed. In an analysis comparing survivors with non-survivors, non-survivors had more diabetes mellitus (DM) (p=0.01), and ischaemic heart disease (IHD) (p=0.04). Age, female sex, peripheral vascular disease and history of coronary artery bypass graft (CABG) were independently associated with increased mortality in our cohort. Also, ventricular tachycardia (VT) and CPR were independently associated with in-hospital mortality. During the study period, there was a significantly decreasing trend in performing CPR in LVAD hospitalisations with CA. CONCLUSION: In conclusion, age, female sex, peripheral vascular disease, history of CABG, VT and CPR were independently associated with in-hospital mortality in LVAD hospitalisations who experienced CA.