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The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices

Authors :
Supriya Shore
Thomas C. Hanff
Jeremy A. Mazurek
Arieh Fox
Monique S. Tanna
Edward W. Grandin
Robert Zhang
Joyce Wald
Carli Peters
Michael A. Acker
Pavan Atluri
J. Eduardo Rame
Lee R. Goldberg
Mariell Jessup
Kenneth B. Margulies
Edo Y. Birati
Source :
Journal of Clinical Medicine; Volume 11; Issue 15; Pages: 4517
Publication Year :
2022
Publisher :
Multidisciplinary Digital Publishing Institute, 2022.

Abstract

We aimed to identify a simple metric accounting for peri-procedural hemoglobin changes, independent of blood product transfusion strategies, and assess its correlation with outcomes in patients undergoing left ventricular assist device (LVAD) implantation We included consecutive patients undergoing LVAD implantation at a single center between 10/1/2008 and 6/1/2014. The anemia stress index (ASI), defined as the sum of number of packed red blood cells transfused and the hemoglobin changes after LVAD implantation, was calculated for each patient at 24 h, discharge, and 3 months after LVAD implantation. Our cohort included 166 patients (80.1% males, mean age 56.3 ± 15.6 years) followed up for a median of 12.3 months. Increases in ASI per unit were associated with a higher hazard for all-cause mortality and early RV failure. The associations between the ASI and all-cause mortality persisted after multivariable adjustment, irrespective of when it was calculated (adjusted HR of 1.11, 95% CI 1.03–1.20 per unit increase in ASI). Similarly, ASI at 24 h after implant was associated with early RV failure despite multivariable adjustment (OR 1.09, 95% CI 1.05–1.14). We present a novel metric, the ASI, that is correlated with an increased risk for all-cause mortality and early RV failure in LVAD recipients.

Details

Language :
English
ISSN :
20770383
Database :
OpenAIRE
Journal :
Journal of Clinical Medicine; Volume 11; Issue 15; Pages: 4517
Accession number :
edsair.doi.dedup.....edcfc4b6820a76dea87efd5b2a81e02a
Full Text :
https://doi.org/10.3390/jcm11154517