Complications of LVAD utilization in older adults.

Background: Yearly rate and mean patient age of left ventricular assist device (LVAD) implantation increased from 2009 to 2014. Data are lacking regarding trends of LVAD implantation in older adults.
Objectives: To describe the trends of LVAD implantation in older adults and the clinical impact of associated procedural complications.
Methods: We retrospectively analyzed the National Inpatient Sample from 2005 to 2014, calculated the percentage of older adults (>65 years of age) among those who underwent LVAD implantation, and compared their clinical characteristics. Primary outcomes were in-hospital mortality and discharge home.
Results: In total, 4491 patients were included. The percentage of older adults among those receiving LVAD increased from 12.53% to 31.65% (p<0.01). Older adults were more likely to develop postoperative delirium (17.90% vs. 11.92% in younger patients; p<0.01), which portended lesser odds of discharge home.
Conclusions: Delirium develops with greater incidence in older adults undergoing LVAD implantation, which decreases odds of favorable discharge disposition.
Competing Interests: Declaration of Competing Interest BA, SK, SN, IAS, BK, and IDG all report receiving in-kind support from medical companies for travel and lodging, food and beverage, and education. All transactions are reported on the OpenPayments website in accordance with the Sunshine Act, and none rise to the level of a conflict of interest.
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