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Characteristics and Outcomes of Pediatric Patients Supported With Ventricular Assist Device-A Multi-Institutional

Kriti Puri1, Marc M Anders2, Sebastian C Tume2

  • 1Lillie Frank Abercrombie Section of Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|June 5, 2019
PubMed

Insights

Pediatric ventricular assist device use is growing, with more patients discharged on support. Congenital heart disease, renal failure, sepsis, stroke, and ECMO increase mortality risk in these children.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Critical Care Medicine

Background:

  • Ventricular assist devices (VADs) are increasingly used in pediatric heart failure patients.
  • This use is associated with significant morbidity and mortality.
  • Understanding outcomes and resource utilization is crucial for improving care.

Purpose of the Study:

  • To describe admission outcomes for pediatric patients receiving VAD support.
  • To analyze resource utilization in this patient population.
  • To identify factors associated with mortality and resource use.

Main Methods:

  • Retrospective cohort analysis of the Pediatric Health Information System database (2006-2015).
  • Included admissions for patients ≤21 years old with VAD implantation.
  • Primary outcome: hospital mortality; secondary outcomes: length of stay and adjusted cost.

Main Results:

  • Analyzed 744 VAD implantations in 740 pediatric patients.
  • Overall hospital mortality was 25%; 53% received a transplant, 19% were discharged on VAD.
  • Factors associated with mortality included congenital heart disease, renal failure, sepsis, stroke, and extracorporeal membrane oxygenation (ECMO).

Conclusions:

  • Pediatric VAD use is increasing, with a higher proportion discharged on support in recent years.
  • Congenital heart disease, renal failure, sepsis, stroke, and ECMO are significant predictors of hospital mortality.
  • Sepsis and VAD replacement/repair correlate with increased costs and longer hospital stays.
Abstract

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