Varughese Vivek Joseph, Nagesh Vignesh Krishnan, Tran Hadrian Hoang-Vu, Wadhwani Nikita, Thu Audrey, Weissman Simcha, Atoot Adam
Department of Internal Medicine, University of South Carolina, Prisma Health, 2 Med Park, Richland, WA 29203, USA.
Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, USA.
Med Sci (Basel). 2025 May 12;13(2):60. doi: 10.3390/medsci13020060.
Aim of the study is to analyze the trends and outcomes in Left Ventricular Assist Device (LVAD) placements between the years 2016 and 2022 using the National Inpatient Sample (NIS).
Using the NIS for the years 2016-2022, we identified the total number of LVAD placements using the PCS 10 code 02HA0QZ. In-hospital outcomes and healthcare resource utilization burden were assessed. Stratification of outcomes with Extracorporeal Membrane Oxygenation (ECMO) support were performed for the years 2018-2022. Outcome analysis variance in admissions requiring ECMO support was performed using multivariate regression analysis. A two tailed -value < 0.05 was used to determine statistical significance.
A general decreasing trend was observed in the total number of LVAD placements, with 852 total admissions requiring LVAD placements identified in 2016 compared to 665 in 2022. The admissions for LVAD placements requiring ECMO support had an increasing trend, with 2.21% of admissions needing ECMO support in 2018 compared to 12.18% in 2018. After multivariate regression analysis, the association between all-cause mortality during the hospital stay for LVAD placements and requirement of ECMO was found to be significant, with an odds ratio of 2.34 (1.83-4.42, -value: 0.001).
A general decreasing trend in LVAD placements was observed between 2016 and 2022. All-cause mortality and hospital charges during the admission had a stable trend over the years. The requirement of ECMO support had an increasing trend from 2018 to 2022. Requirement of ECMO support during the admissions for LVAD placements had a statistically significant association with all-cause mortality during the admission. A 11.50% readmission rate was observed in the 30 days following discharge, with heart failure being the major cause of readmission.
本研究的目的是利用国家住院样本（NIS）分析2016年至2022年间左心室辅助装置（LVAD）植入的趋势和结果。
利用2016 - 2022年的NIS，我们使用PCS 10编码02HA0QZ确定LVAD植入的总数。评估了住院结局和医疗资源利用负担。对2018 - 2022年使用体外膜肺氧合（ECMO）支持的结局进行了分层。使用多变量回归分析对需要ECMO支持的入院结局分析差异。采用双侧P值<0.05来确定统计学显著性。
观察到LVAD植入总数呈总体下降趋势，2016年共有852例需要LVAD植入的入院病例，而2022年为665例。需要ECMO支持的LVAD植入入院病例呈上升趋势，2018年需要ECMO支持的入院病例占2.21%，而2022年为12.18%。多变量回归分析后，发现LVAD植入住院期间全因死亡率与ECMO需求之间的关联具有显著性，比值比为2.34（1.83 - 4.42，P值：0.001）。
2016年至2022年间观察到LVAD植入总体呈下降趋势。多年来，入院期间的全因死亡率和住院费用呈稳定趋势。2018年至2022年，ECMO支持的需求呈上升趋势。LVAD植入入院期间对ECMO支持的需求与入院期间的全因死亡率具有统计学显著关联。出院后30天内的再入院率为11.50%，心力衰竭是再入院的主要原因。
