Trends in LVAD Placements and Outcomes: A Nationwide Analysis Using the National Inpatient Sample and National...

Area of Science:

• Cardiovascular Surgery
• Medical Device Technology
• Health Services Research

Background:

• Analysis of Left Ventricular Assist Device (LVAD) placement trends and outcomes from 2016-2022.
• Utilizing the National Inpatient Sample (NIS) database for comprehensive data.
• Focus on in-hospital outcomes and healthcare resource utilization.

Purpose of the Study:

• To analyze temporal trends in LVAD placements.
• To evaluate in-hospital outcomes and resource utilization associated with LVADs.
• To investigate the impact of Extracorporeal Membrane Oxygenation (ECMO) support on LVAD outcomes.

Main Methods:

• National Inpatient Sample (NIS) data from 2016-2022.
• Identification of LVAD placements using ICD-10 code 02HA0QZ.
• Stratification of outcomes by ECMO support (2018-2022) and multivariate regression analysis.

Main Results:

• A decreasing trend in overall LVAD placements (852 in 2016 to 665 in 2022).
• An increasing trend in LVAD admissions requiring ECMO support (2.21% in 2018 to 12.18% in 2022).
• Significant association between ECMO requirement and in-hospital all-cause mortality (OR 2.34, p=0.001).

Conclusions:

• Overall LVAD placement numbers declined, while ECMO utilization increased.
• In-hospital mortality and hospital charges remained stable.
• ECMO support during LVAD implantation is a significant predictor of in-hospital mortality.
• Heart failure is the primary cause for a 11.50% 30-day readmission rate.