Left Ventricular Device Implantation Impacts on Hospitalisation Rates, Length of Stay and Out of Hospital Time

Prichard, R.; Kershaw, Louise; Goodall, Stephen; Davidson, Patricia M.; Newton, Phillip J.; McNeil, F.M.; Homer, T.; Hayward, Christopher

doi:10.1016/j.hlc.2017.06.717

Cited by 4 publications

(6 citation statements)

References 25 publications

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“…The median LOS for registry patients admitted for HF ranged from 4 to 15 days in the Etude Française de l'Insuffisance Cardiaque Aigue (EFICA) study, which only included ICU patients. In the Australian study, patients spent a total of 7.5% of the days in the year before transplantation in hospital 20. In our study, 66.6% of all patients were admitted to ICU at least once before the THS, compared with 15.2% of patients in the Acute Decompensated Heart Failure National Registry,21 22.3% of patients hospitalised for the first time for HF in France3 and 42.9% of patients in the Observatoire national de l'Insuffisance Cardiaque Aigue (OFICA) study 22…”

Section: Discussionmentioning

confidence: 58%

“…The mean LOS of the THS, including preoperative and postoperative periods, was 51.5 days, with mean and median intervals between admission and transplantation of 14 and 5 days, respectively. Data from the United Network for Organ Sharing (UNOS) registry show a median LOS (IQR) after isolated heart transplantation in adults discharged alive between 2003 and 2012 of 14 days 10–20 24. In this cohort of 16 723 patients, 2020 were hospitalised for more than 30 days after transplantation.…”

Section: Discussionmentioning

confidence: 95%

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Hospitalisation and life support in the year before and during heart transplantation: a French national study

Cantrelle

Dorent²,

Legeai³

et al. 2018

Open Heart

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ObjectiveThe objective of this study was to define the characteristics of hospital care use during the year prior to heart transplantation.MethodsA retrospective cohort of heart transplant recipients registered on the national hospital discharge database between 2010 and 2015 was analysed.ResultsIn this cohort of 2379 heart transplant recipients (mean age: 48 years, 74% men), 91% had been admitted at least once, for at least 1 day, to a short-stay hospital during the year before transplantation (mean: 4.3 days), and 84% had at least one cardiovascular diagnosis (heart failure and cardiogenic shock: 60%). At least one intensive care stay was reported for 61% of patients, a rehabilitation stay was reported for 30%, mechanical circulatory support was reported for 12%, and ventilatory support was reported for 15%. The median interval between admission and transplantation was 5 days (interquartile QI–Q3, 0–16). The hospital mortality was higher for patients not hospitalised before transplantation (18% vs 15%). Their transplantation hospitalisation diagnosis, compared with patients hospitalised before transplantation, was more frequently cardiomyopathy (31% vs 27%) or heart failure (28% vs 18%), and less frequently myocardial infarction (1% vs 12%).ConclusionThis study demonstrates a high hospitalisation rate before heart transplantation and identifies three groups of patients: 1—patients with a high hospitalisation rate and terminal heart failure requiring circulatory support who experienced at least one intensive care unit stay; 2—patients with a history of hospitalisation, mainly for heart disease, without circulatory support requirement; and 3—patients with no pretransplantation overnight stay. These findings provide useful information to evaluate the medical benefits and needs for transplantation, and identify areas for improvement in heart transplantation listing criteria.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 95%

Hospitalisation and life support in the year before and during heart transplantation: a French national study

Cantrelle

Dorent²,

Legeai³

et al. 2018

Open Heart

View full text Add to dashboard Cite

show abstract

“…Approximately 30% of the LVAD recipients are readmitted within 30 days after their initial discharge, 16,17 and even more than 60%–80% is at least once readmitted 1 year after their initial discharge 18 . On average, LVAD patients are admitted twice during the first year on LVAD support 6,19 . These frequent hospitalizations have a significant negative impact on the quality of life of these patients and places a large burden on hospital resources.…”

Section: Commentmentioning

confidence: 99%

“…Despite these improvements, early and late LVAD‐related complications, such as right ventricular (RV) failure, acute kidney injury (AKI), LVAD‐related infections and major gastro‐intestinal bleedings, are still frequent 3–5 . Rehospitalization and complication rates in the out‐patient phase of LVAD patients remain very high 6 . There is a great clinical need for physicians treating LVAD patients to have additional tools to monitor patient management, especially remotely outside the hospital.…”

Section: Introductionmentioning

confidence: 99%

“… 3 , 4 , 5 Rehospitalization and complication rates in the out‐patient phase of LVAD patients remain very high. 6 There is a great clinical need for physicians treating LVAD patients to have additional tools to monitor patient management, especially remotely outside the hospital. Currently, no remote monitoring tools are used in LVAD care, except physical signs, such as weight and rhythm.…”

Section: Introductionmentioning

confidence: 99%

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Safety and feasibility of hemodynamic pulmonary artery pressure monitoring using the CardioMEMS device in LVAD management

Veenis

Radhoe

Mieghem

et al. 2021

Journal of Cardiac Surgery

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Background There is a clinical need for additional remote tools to improve left ventricular assist device (LVAD) patient management. The aim of this pilot concept study was to assess the safety and feasibility of optimizing patient management with add‐on remote hemodynamic monitoring using the CardioMEMS in LVAD patients during different treatment stages. Methods Ten consecutive patients accepted and clinically ready for (semi‐) elective HeartMate 3 LVAD surgery were included. All patients received a CardioMEMS to optimize filling pressure before surgery. Patients were categorized into those with normal mean pulmonary artery pressure (mPAP) (≤25 mmHg, n = 4) or elevated mPAP (>25 mmHg, n = 6), and compared to a historical cohort (n = 20). Endpoints were CardioMEMS device safety and a combined endpoint of all‐cause mortality, acute kidney injury, renal replacement therapy and/or right ventricular failure at 1‐year follow‐up. Additionally, we investigated hospital‐free survival and improvement in quality of life (QoL) and exercise tolerance. Results No safety issues or signal interferences were observed. The combined endpoint occurred in 60% of historical controls, 0% in normal and 83% in elevated mPAP group. Post‐discharge, the hospital‐free survival was significantly better, and the QoL improved more in the normal compared to the elevated mPAP group. Conclusion Remote hemodynamic monitoring in LVAD patients is safe and feasible with the CardioMEMS, which could be used to identify patients at elevated risk of complications as well as optimize patient management remotely during the out‐patient phase with less frequent hospitalizations. Larger pivotal studies are warranted to test the hypothesis generated from this concept study.

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Costs Before and After Left Ventricular Assist Device Implant and Preceding Heart Transplant: A Cohort Study

Prichard

Kershaw

Goodall

et al. 2020

Heart, Lung and Circulation

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Left Ventricular Device Implantation Impacts on Hospitalisation Rates, Length of Stay and Out of Hospital Time

Cited by 4 publications

References 25 publications

Hospitalisation and life support in the year before and during heart transplantation: a French national study

Hospitalisation and life support in the year before and during heart transplantation: a French national study

Safety and feasibility of hemodynamic pulmonary artery pressure monitoring using the CardioMEMS device in LVAD management

Costs Before and After Left Ventricular Assist Device Implant and Preceding Heart Transplant: A Cohort Study

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