Patient factors associated with left ventricular assist device infections: A scoping review

Pienta, Michael J.; Shore, Supriya; Watt, Tessa M.F.; Yost, Gardner; Townsend, Whitney; Cabrera, Lourdes; Fetters, Michael D.; Chenoweth, Carol E.; Aaronson, Keith D.; Pagani, Francis D.; Likosky, Donald S.

doi:10.1016/j.healun.2022.01.011

Cited by 11 publications

(15 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…2 The infections are associated with increased morbidity, mortality, and expenditures. 1 Although several patient factors have been evaluated as risk factors, none of the assessed factors have been consistently associated with infections. 1 In addition, only two non-patient factors were consistently associated with lower infection risk in LVAD recipients: increasing experience and establishing a silicone-skin interface at driveline exit site.…”

Section: Introductionmentioning

confidence: 99%

“…1 Although several patient factors have been evaluated as risk factors, none of the assessed factors have been consistently associated with infections. 1 In addition, only two non-patient factors were consistently associated with lower infection risk in LVAD recipients: increasing experience and establishing a silicone-skin interface at driveline exit site. Nevertheless, the large variability in reporting across multiple studied interventions limits the ability to discern their effectiveness.…”

Section: Introductionmentioning

confidence: 99%

“…Driveline infection is a frequent complication in recipients of durable left ventricular assist devices (LVAD). 1 It affects 12%-35% of recipients. 2 The infections are associated with increased morbidity, mortality, and expenditures.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vitamin D deficiency and driveline infection in patients with a left ventricular assist device implant

et al. 2023

View full text Add to dashboard Cite

Driveline infection is a frequent complication in recipients of durable left ventricular assist devices (LVAD), but its cause is largely unclear. Since vitamin D supplementation can reduce the risk of infections, we aimed at investigating the association of vitamin D deficiency with driveline infection. In 154 patients with continuous flow LVAD implants, we assessed 2-year risk of driveline infection according to vitamin D status (circulating 25-hydroxyvitamin D < 25 nmol/L or ⩾25 nmol/L). Of the study cohort, 34% ( n = 53) had 25-hydroxyvitamin D concentrations <25 nmol/L. Kaplan-Meir estimates of 2-year freedom from driveline infection were in the vitamin D deficient and vitamin D non-deficient groups 49.7% and 74.2%, respectively ( p = 0.017). Covariate-adjusted hazard ratio of driveline infection for the vitamin D deficient versus non-deficient group was 2.51 [95% CI: 1.11–5.69; p = 0.028). Circulating concentrations of endocrine regulators of calcium and phosphorus metabolism such as parathyroid hormone, 1,25-dihydroxyvitamin D, and fibroblast growth factor-23 were not significantly associated with the risk of driveline infection ( p-values > 0.15). In total, our data indicate that in LVAD recipients deficient vitamin D status is a predictor of driveline infection, but future studies are needed to investigate whether these associations are causal.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Vitamin D deficiency and driveline infection in patients with a left ventricular assist device implant

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Recent reviews of the literature examining nonpatient-related factors and patient factors associated with infection in LVAD recipients have identified that the majority of studies investigating infection in the setting of durable LVAD therapy are single-center, observational studies. 6,8,9 These literature reviews have identified only two nonpatient factors consistently associated with a lower risk of infection in patients receiving durable LVAD implant: 1) increasing center experience and 2) establishing a silicone-skin interface at the driveline exit site. 8 With regard to patient factors, patient race, and sex did not correlate with infection risk.…”

mentioning

confidence: 99%

“…Additionally, no consistent association has been noted between obesity, diabetes, or psychosocial/socio-economic factors and infections in patients supported with durable LVADs. 9 Only two observational studies have reported a significant association between malnutrition and hypoalbuminemia and postimplant infections in LVAD recipients. 9 Patient-related comorbidities, especially body composition and diabetes, were the most common comorbidities evaluated but were not shown to be consistently associated with infections following durable LVAD implantation.…”

mentioning

confidence: 99%

Driveline Infections Associated With Durable Left Ventricular Assist Device Support: An Ounce of Prevention is Worth a Pound of Cure

Pagani

2022

ASAIO Journal

Self Cite

View full text Add to dashboard Cite

Artificial intelligence‐based analysis of body composition predicts outcome in patients receiving long‐term mechanical circulatory support

Just,

Schoenrath,

Roehrich

et al. 2023

J cachexia sarcopenia muscle

View full text Add to dashboard Cite

BackgroundObesity is a known cardiovascular risk factor and associated with higher postoperative complication rates in patients undergoing cardiac surgery. In heart failure (HF), conflicting evidence in terms of survival has been reported, whereas sarcopenia is associated with poor prognosis. An increasing number of HF patients require left ventricular assist device (LVAD) implantations. The postoperative mortality has improved in recent years but is still relatively high. The impact of body composition on outcome in this population remains unclear. The aim of this investigation was to examine the preoperative computed tomography (CT) body composition as a predictor of the postoperative outcome in advanced HF patients, who receive LVAD implantations.MethodsPreoperative CT scans of 137 patients who received LVADs between 2015 and 2020 were retrospectively analysed using an artificial intelligence (AI)‐powered automated software tool based on a convolutional neural network, U‐net, developed for image segmentation (Visage Version 7.1, Visage Imaging GmbH, Berlin, Germany). Assessment of body composition included visceral and subcutaneous adipose tissue areas (VAT and SAT), psoas and total abdominal muscle areas and sarcopenia (defined by lumbar skeletal muscle indexes). The body composition parameters were correlated with postoperative major complication rates, survival and postoperative 6‐min walk distance (6MWD) and quality of life (QoL).ResultsThe mean age of patients was 58.21 ± 11.9 years; 122 (89.1%) were male. Most patients had severe HF requiring inotropes (Interagency Registry for Mechanically Assisted Circulatory Support [INTERMACS] profile I–III, 71.9%) secondary to coronary artery diseases or dilated cardiomyopathy (96.4%). Forty‐four (32.1%) patients were obese (body mass index ≥ 30 kg/m2), 96 (70.1%) were sarcopene and 19 (13.9%) were sarcopene obese. Adipose tissue was associated with a significantly higher risk of postoperative infections (VAT 172.23 cm2 [54.96, 288.32 cm2] vs. 124.04 cm2 [56.57, 186.25 cm2], P = 0.022) and in‐hospital mortality (VAT 168.11 cm2 [134.19, 285.27 cm2] vs. 135.42 cm2 [49.44, 227.91 cm2], P = 0.033; SAT 227.28 cm2 [139.38, 304.35 cm2] vs. 173.81 cm2 [97.65, 254.16 cm2], P = 0.009). Obese patients showed no improvement of 6MWD and QoL within 6 months postoperatively (obese: +0.94 ± 161.44 months, P = 0.982; non‐obese: +166.90 ± 139.00 months, P < 0.000; obese: +0.088 ± 0.421, P = 0.376; non‐obese: +0.199 ± 0.324, P = 0.002, respectively). Sarcopenia did not influence the postoperative outcome and survival within 1 year after LVAD implantation.ConclusionsPreoperative AI‐based CT body composition identifies patients with poor outcome after LVAD implantation. Greater adipose tissue areas are associated with an increased risk for postoperative infections, in‐hospital mortality and impaired 6MWD and QoL within 6 months postoperatively.

show abstract

Patient factors associated with left ventricular assist device infections: A scoping review

Cited by 11 publications

References 44 publications

Vitamin D deficiency and driveline infection in patients with a left ventricular assist device implant

Vitamin D deficiency and driveline infection in patients with a left ventricular assist device implant

Driveline Infections Associated With Durable Left Ventricular Assist Device Support: An Ounce of Prevention is Worth a Pound of Cure

Artificial intelligence‐based analysis of body composition predicts outcome in patients receiving long‐term mechanical circulatory support

Contact Info

Product

Resources

About