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Ventricular Assist Device Implantation in the Elderly: Nationwide Outcomes in the United States
- Source :
- Journal of Cardiac Surgery. 28:183-189
- Publication Year :
- 2013
- Publisher :
- Hindawi Limited, 2013.
-
Abstract
- Background The aim of this study was to evaluate nationwide outcomes of ventricular assist device (VAD) implantation in elderly patients in the United States. Methods Patients undergoing VAD implantation between 2003 and 2008 were identified in the Nationwide Inpatient Sample. The primary outcome was inpatient mortality following VAD implantation. Secondary outcomes included disposition following discharge and costs of care. After stratification based on primary versus postcardiotomy VAD support, outcomes were compared between controls aged 60–69 years and elderly patients aged ≥70 years. Results A total of 2787 patients aged 60–69 years and 1472 patients aged ≥70 years underwent VAD implantation during the study period. Unadjusted mortality rates were comparable between elderly and control patients in both primary support (35.7% vs. 32.1%, p = 0.61) and postcardiotomy support (58.1% vs. 56.1%, p = 0.70). Similarly, in risk-adjusted multivariable logistic regression analysis incorporating clinically relevant variables, age ≥70 did not exert an independent effect on inpatient mortality for either indication. Inpatient costs in the elderly were lower than controls in the primary support cohort, although costs per day were similar, with comparable overall costs between age groups in the postcardiotomy cohort. Elderly survivors were discharged to a facility more frequently than control survivors (primary: 49.9% vs. 29.6%, p = 0.007; postcardiotomy: 67.4% vs. 45.7%, p = 0.03). Conclusions This large-cohort population-based analysis provides a useful framework for inpatient prognosis and resource utilization in elderly patients undergoing VAD implantation. Although mortality rates and costs were found to be comparable between elderly patients and those aged 60–69 years, these rates were nonetheless significant. This combined with more frequent discharge-to-facility in elderly survivors underscores the importance of careful patient selection in this population. doi: 10.1111/jocs.12066 (J Card Surg 2013;28:183–189)
- Subjects :
- Pulmonary and Respiratory Medicine
Pediatrics
medicine.medical_specialty
education.field_of_study
Inpatient mortality
business.industry
medicine.medical_treatment
Mortality rate
Population
Logistic regression
humanities
Surgery
Age groups
Ventricular assist device
Cohort
medicine
Cardiology and Cardiovascular Medicine
business
education
Resource utilization
Subjects
Details
- ISSN :
- 08860440
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Journal of Cardiac Surgery
- Accession number :
- edsair.doi...........87d11b5e7d12fcd691fa1c07611d1c85