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Severity of End-Organ Damage as a Predictor of Outcomes After Implantation of Left Ventricular Assist Device
- Source :
- ASAIO Journal. 61:127-132
- Publication Year :
- 2015
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2015.
-
Abstract
- The optimal timing of left ventricular assist device (LVAD) implantation in the management of advanced heart failure remains controversial. We hypothesize that in patients with cardiogenic shock, the severity of end-organ dysfunction as determined by the sequential organ failure assessment (SOFA) score is a determinant of outcomes after LVAD implantation. We determined the preoperative SOFA score and short- and long-term outcomes of 97 consecutive patients who received HeartMate II or HeartWare LVAD at our institution since January 2007. Kaplan-Meier analysis was used to compare long-term survival across SOFA score subgroups. The overall 30 day mortality was 10.1%, with no significant difference among SOFA score subgroups. Patients with scores ≥9 had significantly longer hospital stay (26 ± 6 vs. 18 ± 10 days, p = 0.03). One-year survival for SOFA scores 0-2, 3-5, 6-8, and ≥9 was 94%, 75%, 64%, and 29%, respectively. SOFA score was significantly lower in survivors at 6, 9, 12, 24, and 36 months. SOFA score did not predict adverse outcomes of bleeding, cerebrovascular events, infection, or pump exchange. These results show that preoperative SOFA score is a powerful predictor of outcomes after LVAD implantation. Long-term outcomes can be significantly improved by early intervention before emergence of end-organ dysfunction.
- Subjects :
- Male
medicine.medical_specialty
Organ Dysfunction Scores
End organ damage
medicine.medical_treatment
Shock, Cardiogenic
Biomedical Engineering
Biophysics
Bioengineering
Kaplan-Meier Estimate
Cohort Studies
Biomaterials
Internal medicine
medicine
Humans
Aged
Heart Failure
Heartmate ii
business.industry
Cardiogenic shock
Significant difference
General Medicine
Middle Aged
medicine.disease
respiratory tract diseases
Treatment Outcome
ROC Curve
30 day mortality
Ventricular assist device
Heart failure
Cardiology
Heart Transplantation
Female
SOFA score
Heart-Assist Devices
business
Subjects
Details
- ISSN :
- 10582916
- Volume :
- 61
- Database :
- OpenAIRE
- Journal :
- ASAIO Journal
- Accession number :
- edsair.doi.dedup.....a535d55aba2cd12cf78253b78adcadbb
- Full Text :
- https://doi.org/10.1097/mat.0000000000000185