Bosch Lena, Zwetsloot Peter-Paul M, Brons Maaike, van Hout Gerardus P J, van der Meer Manon G, Szymanski Mariusz K, Troost-Oppelaar Anne-Marie, Ramjankhan Faiz Z, van der Harst Pim, Gianoli Monica, Oerlemans Marish I F J, van Laake Linda W
Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Transplantation Centre, University Medical Centre Utrecht, Utrecht, The Netherlands.
Neth Heart J. 2024 Sep;32(9):317-325. doi: 10.1007/s12471-024-01885-5. Epub 2024 Aug 14.
A left ventricular assist device (LVAD) is a life-saving but intensive therapy for patients with end-stage heart failure. We evaluated the healthcare consumption in a cohort of LVAD patients in our centre over 6 years.
All patients with a primary LVAD implantation at the University Medical Centre Utrecht in Utrecht, the Netherlands from 2016 through 2021 were included in this analysis. Subsequent hospital stay, outpatient clinic visits, emergency department visits and readmissions were recorded.
During the investigated period, 226 LVADs were implanted, ranging from 32 in 2016 to 45 in 2020. Most LVADs were implanted in patients aged 40-60 years, while they were supported by or sliding on inotropes (Interagency Registry for Mechanically Assisted Circulatory Support class 2 or 3). Around the time of LVAD implantation, the median total hospital stay was 41 days. As the size of the LVAD cohort increased over time, the total annual number of outpatient clinic visits also increased, from 124 in 2016 to 812 in 2021 (p = 0.003). The numbers of emergency department visits and readmissions significantly increased in the 6‑year period as well, with a total number of 553 emergency department visits and 614 readmissions. Over the years, the annual number of outpatient clinic visits decreased by 1 per patient-year follow-up, while the annual numbers of emergency department visits and readmissions per patient-year remained stable.
The number of patients supported by an LVAD has grown steadily over the last years, requiring a more specialised healthcare in this particular population.
左心室辅助装置（LVAD）是一种用于终末期心力衰竭患者的挽救生命但强度较大的治疗方法。我们评估了本中心6年间LVAD患者队列的医疗资源消耗情况。
纳入2016年至2021年在荷兰乌得勒支大学医学中心首次植入LVAD的所有患者。记录随后的住院时间、门诊就诊次数、急诊就诊次数和再入院情况。
在研究期间，共植入226例LVAD，从2016年的32例到2020年的45例不等。大多数LVAD植入40 - 60岁的患者体内，这些患者当时正接受血管活性药物支持或在血管活性药物辅助下（机械辅助循环支持机构注册分级为2级或3级）。在LVAD植入前后，住院总时间中位数为41天。随着LVAD队列规模随时间增加，门诊就诊的年度总数也增加，从2016年的124次增加到2021年的812次（p = 0.003）。急诊就诊次数和再入院次数在6年期间也显著增加，急诊就诊总数为553次，再入院总数为614次。多年来，每位患者每年的门诊就诊次数减少1次，而每位患者每年的急诊就诊次数和再入院次数保持稳定。
在过去几年中，接受LVAD支持的患者数量稳步增长，但这一特定人群需要更专业化的医疗服务。
