Premium
Racial disparities in in‐hospital outcomes after left ventricular assist device implantation
Author(s) -
Ueyama Hiroki,
Malik Aaqib,
Kuno Toshiki,
Yokoyama Yujiro,
Briasouli Artemis,
Shetty Suchith,
Briasoulis Alexandros
Publication year - 2020
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.14859
Subject(s) - medicine , medicaid , stroke (engine) , ventricular assist device , hemodialysis , quartile , coronary artery disease , tamponade , heart failure , diabetes mellitus , cardiology , surgery , health care , confidence interval , endocrinology , mechanical engineering , engineering , economics , economic growth
Abstract Background Previous studies of patients undergoing various cardiac surgeries demonstrated worse outcomes among African‐American (AA) patients. It remains unclear if the race is a predictor of outcomes among left ventricular assist device (LVAD) recipients. Methods Patients who underwent LVAD implantation between 2010 and 2017 were identified using the National Inpatient Sample. The race was classified as Caucasians vs AA vs Hispanics, and endpoints were in‐hospital outcomes, length of stay, and cost. Procedure‐related complications were identified via the International Classification of Diseases‐9 (ICD‐9) and ICD‐10 coding and analysis performed via mixed‐effect models. Results A total of 27 132 adults (5114 unweighted) underwent LVAD implantation in the U.S. between 2010 and 2017, including Caucasians (63.8%), AA (23.8%), and Hispanics (6%). The number of LVAD implantations increased in both Caucasians and AA during the study period. AA LVAD recipients were younger, with higher rates of females and mostly comorbidities, but lower rates of coronary artery disease and bypass grafting compared to Caucasians and Hispanics. Medicaid and median income at the lowest quartile were more frequent among AA LVAD recipients. We did not identify differences in stroke, bleeding complications, tamponade, infectious complications, acute kidney injury requiring hemodialysis, and in‐hospital mortality among racial groups. AA LVAD recipients had lower rates of routine discharge than Caucasians and Hispanics, longer length of stay than Caucasians, but similar cost of hospitalization. After adjustment for clinical comorbidities, race was not a predictor of in‐hospital mortality. Conclusion We identified differences in clinical characteristics but not in in‐hospital complications among LVAD recipients of a different races.