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Use of a Percutaneous Ventricular Assist Device/Left Atrium to Femoral Artery Bypass System for Cardiogenic Shock
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Clinical Predictors for Repeat Hospitalizations in Left Ventricular Assist Device (LVAD) Patients With
Charles V Welden1, Wiley Truss2, Gerald McGwin3
1University of Alabama School of Medicine, AL 35233, USA.
Gastroenterology Research
|May 1, 2018
Summary
Gastrointestinal bleeding (GIB) is common in left ventricular assist device (LVAD) patients, leading to high readmission rates. Early endoscopy and better INR control can significantly reduce repeat GIB hospitalizations.
Area of Science:
- Cardiology
- Gastroenterology
- Medical Devices
Background:
- Left ventricular assist devices (LVADs) are crucial for end-stage heart failure but increase gastrointestinal bleeding (GIB) risk.
- High rates of recurrent GIB hospitalizations necessitate identifying predictive factors for improved patient management.
Purpose of the Study:
- To investigate clinical predictors associated with repeat gastrointestinal bleeding hospitalizations in patients with continuous-flow left ventricular assist devices (CF-LVADs).
Main Methods:
- Retrospective cohort study of 102 CF-LVAD patients from Jan 2009 to Dec 2013.
- Analysis of clinical data, GIB events, hospitalizations, and endoscopic procedures.
Main Results:
- 31.4% of patients experienced GIB, with 56.3% requiring readmission.
- Early endoscopy (<48h) was associated with a 57% reduction in future readmissions.
- Factors linked to repeat admissions included male gender, longer initial hospital stay, and elevated INR on admission.
Conclusions:
- Gastrointestinal bleeding in LVAD patients presents a significant challenge with high readmission rates.
- Early endoscopy, extended initial hospital stay, and optimized INR control are key modifiable factors to decrease GIB readmissions.
- Addressing these factors can reduce the burden of recurrent GIB hospitalizations in LVAD recipients.
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