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Insertion, Maintenance, and Removal of the Percutaneous Dual Lumen Cannula Right Ventricular Assist Device
Published on: July 20, 2022
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Resource utilization in children with paracorporeal continuous-flow ventricular assist devices
Danielle S Burstein1, Heather Griffis2, Xuemei Zhang2
1Division of Cardiology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Summary
Paracorporeal continuous-flow ventricular assist devices (PCF VAD) in children are associated with high resource utilization and prolonged hospital stays. Costs are mainly driven by patient illness, length of stay, and clinical care expenses.
Area of Science:
- Pediatric Cardiology
- Medical Device Technology
- Healthcare Resource Management
Background:
- Paracorporeal continuous-flow ventricular assist devices (PCF VAD) are increasingly utilized in pediatric patients.
- Limited data exists on the resource utilization of PCF VAD in children.
Purpose of the Study:
- To analyze and report the resource utilization of PCF VAD in pediatric patients.
- To compare resource utilization across different VAD strategies in children.
Main Methods:
- Merged data from the Pediatric Interagency Registry for Mechanically Assisted Circulatory Support (PediMACS) and Pediatric Health Information System (PHIS).
- Analyzed resource utilization including hospital and intensive care unit length of stay (LOS) and costs for PCF VAD, durable VAD (DVAD), and combined PCF-DVAD support.
- Included data from 19 centers between 2012 and 2016 for 177 children.
Main Results:
- Patients with PCF VAD or PCF-DVAD were younger and more likely to have congenital heart disease compared to DVAD recipients.
- Median post-VAD length of stay was prolonged for PCF VAD (43 days) and PCF-DVAD (72 days), with significant associated hospitalization costs.
- Higher daily costs for PCF VAD were linked to increased pharmacy, laboratory, imaging, and clinical services.
Conclusions:
- Pediatric PCF VAD resource utilization is substantial, characterized by high costs.
- Key cost drivers include pre-implantation patient illness, hospital length of stay, and clinical care expenses.
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