Outcomes of Cardiac Arrest and Cardiopulmonary Resuscitation in Patients With Left Ventricular Assist Device; an Insight From a National Inpatient Sample - 10/01/22

Doi : 10.1016/j.hlc.2021.05.096

Kirolos Barssoum, MD ^a,^b,^⁎,^{^{1
Kirolos Barssoum, Harsh Patel and Devesh Rai contributed equally to this manuscript.}} , Harsh Patel, MD ^c,^{^{1
Kirolos Barssoum, Harsh Patel and Devesh Rai contributed equally to this manuscript.}}, Devesh Rai, MD ^a,^{^{1
Kirolos Barssoum, Harsh Patel and Devesh Rai contributed equally to this manuscript.}}, Ashish Kumar, MD ^d, Mohab Hassib, MD ^e, Hasan F. Othman, MD ^f, Samarthkumar Thakkar, MD ^a, Ahmed El Karyoni, MD ^g, Osarenren Idemudia, MD ^b, Fadi Ibrahim, MD ^h, Tala Salem, MD ^b, Mariam Shariff, MD ⁱ, Ahmad Jabri, MD ^j, Ayman ElBadawi, MD ^k,^l, Soidjon Khodjaev, MD ^m, Dhrubajyoti Bandyopadhyay, MD ⁿ, Wilbert S. Aronow, MD ⁿ, Vishal Parikh, MD ^m, Mohan Rao, MD ^o, Park Soon, MD ^m
^a Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
^b Department of Internal Medicine, Unity Hospital, Rochester Regional Health System, Rochester, NY, USA
^c Department of Internal Medicine, Louis A Weiss Memorial Hospital, Chicago, IL, USA
^d Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA
^e St. Francis Medical Center, Trenton, NJ, USA
^f Michigan State University/Sparrow Health System, Lansing, MI, USA
^g Cardiovascular Department, Loyola University Medical Center, IL, USA
^h American University of Antigua, Antigua and Barbuda
ⁱ Department of General Surgery, Mayo Clinic, Rochester, MN, USA
^j Heart and Vascular Center, Case Western Reserve University/MetroHealth Medical Center, Cleveland, OH, USA
^k Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, USA
^l Department of Cardiovascular Medicine, Ain Shams University, Cairo, Egypt
^m Department of Advanced Heart Failure and Transplant, Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA
ⁿ Department of Cardiology, New York Medical College at Westchester Medical Center, New York, NY, USA
^o Department of Cardiology, Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA

^∗Corresponding author at: Department of Internal Medicine, Rochester General Hospital, Rochester, New York, USADepartment of Internal MedicineRochester General HospitalRochesterNew YorkUSA

Abstract

Background

Outcomes of patients with implanted left ventricular assist device (LVAD) implantation experiencing a cardiac arrest (CA) are not well reported. We aimed at defining the in-hospital outcomes of patients with implanted LVAD experiencing a CA.

Methods

The national inpatient sample (NIS) was queried using ICD9/ICD10 codes for patients older than 18 years with implanted LVAD and CA between 2010–2018. We excluded patients with orthotropic heart transplantation, biventricular assist device (BiVAD) implantation and do not resuscitate (DNR) status.

Results

A total of 93,153 hospitalisations between 2010 and 2018 with implanted LVAD were identified. Only 578 of these hospitalisations had experienced CA and of those, 173 (33%) hospitalisations underwent cardiopulmonary resuscitation (CPR). The mean age of hospitalisations that experienced a CA was 60.61±14.85 for non-survivors and 56.23±17.33 for survivors (p=0.14). The in-hospital mortality was 60.8% in hospitalisations with CA and 74.33% in hospitalisations in whom CPR was performed. In an analysis comparing survivors with non-survivors, non-survivors had more diabetes mellitus (DM) (p=0.01), and ischaemic heart disease (IHD) (p=0.04). Age, female sex, peripheral vascular disease and history of coronary artery bypass graft (CABG) were independently associated with increased mortality in our cohort. Also, ventricular tachycardia (VT) and CPR were independently associated with in-hospital mortality. During the study period, there was a significantly decreasing trend in performing CPR in LVAD hospitalisations with CA.

Conclusion

In conclusion, age, female sex, peripheral vascular disease, history of CABG, VT and CPR were independently associated with in-hospital mortality in LVAD hospitalisations who experienced CA.

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Keywords : Left ventricular assist device, Cardiac arrest, CPR, Mortality

Plan

Introduction

Methods

Data Source

Study Design and Population

Definition of Variables

Outcomes Measured

Statistical Analysis

Results

Survivors Versus Non-Survivors

CPR Versus No CPR

Discussion

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Vol 31 - N° 2

P. 246-254 - février 2022 Retour au numéro

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Outcomes of Cardiac Arrest and Cardiopulmonary Resuscitation in Patients With Left Ventricular Assist Device; an Insight From a National Inpatient Sample - 10/01/22

Abstract

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Conclusion

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