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Continuous-flow devices and percutaneous site infections: Clinical outcomes
- Source :
-
Journal of Heart & Lung Transplantation . Nov2012, Vol. 31 Issue 11, p1151-1157. 7p. - Publication Year :
- 2012
-
Abstract
- Background: Although continuous-flow left ventricular assist device (LVAD) support has become standard therapy, the complexities of device and patient management remain a challenge. In particular, percutaneous site infections (PSI) are a serious complication during the post-implant course. We sought to study the incidence, risk factors, and clinical effect of PSI. Methods: Data were obtained from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) Registry. All adult patients who received a primary intracorporeal continuous flow LVAD between June 2006 and September 2010 were included. Descriptive statistics, Kaplan-Meier depictions, and multivariable analysis in the parametric hazard domain were used for statistical analysis. Results: A total of 239 PSIs were documented in 197 of 2,006 recipients (9.8%) of a continuous-flow LVAD. Mean follow-up was 8.1 months. Mean time to development of a PSI was 6.6 months. At 1 year after implant, nearly 19% of continuous-flow LVAD recipients developed a PSI. Multivariate analysis showed younger age (hazard ratio, 1.20; p < 0.0001) was the only factor predicting a PSI. Continuous-flow LVAD recipients who did not develop a PSI had improved survival (p = 0.004). Twenty-three patients died after development of a PSI. Sepsis was the most common cause of death (26.1%). Conclusions: PSIs occur in approximately 19% of continuous-flow LVAD recipients by 12 months after implant. Young age is the only predictor of PSI. Importantly, development of a PSI adversely affects survival. Efforts to enhance driveline integration and to develop future totally implantable systems are warranted. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 10532498
- Volume :
- 31
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Journal of Heart & Lung Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 82428459
- Full Text :
- https://doi.org/10.1016/j.healun.2012.05.004