National Landscape of Unplanned 30-Day Readmissions in Patients With Left Ventricular Assist Device Implantation

Shanti Patel, Priti Poojary, Sumeet Pawar, Aparna Saha, Achint Patel, Kinsuk Chauhan, Ashish Correa, Pratik Mondal, Kanika Mahajan, Lili Chan, Rocco Ferrandino, Dhruv Mehta, Shiv Kumar Agarwal, Narender Annapureddy, Jignesh Patel, Paul Saunders, Gregory Crooke, Jacob Shani, Tariq Ahmad, Nihar DesaiGirish N. Nadkarni, Vijay Shetty

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

The number of patients with advanced heart failure receiving left ventricular assist device (LVAD) implantation has increased dramatically over the last decade. There are limited data available about the nationwide trends of complications leading to readmissions after implantation of contemporary devices. Patients who underwent LVAD implantation from January 2013 to December 2013 were identified using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) code 37.66 from the Healthcare Cost and Utilization Project's National Readmission Database. The top causes of unplanned 30-day readmission after LVAD implantation were determined. Survey logistic regression was used to analyze the significant predictors of readmission. In 2013, there were 2,235 patients with an LVAD implantation. Of them, 665 (29.7%) had at least 1 unplanned readmission within 30 days, out of which 289 (43.4%) occurred within 10 days after discharge. Implant complications (14.9%), congestive heart failure (11.7%), and gastrointestinal bleeding (8.4%) were the top 3 diagnoses for the first readmission and accounted for more than a third of all readmissions. Significant predictors of readmissions included a prolonged length of stay during the index admission, Medicare insurance, and discharge to short-term facility. In conclusion, despite increased experience with LVADs, unplanned readmissions within 30 days of implantation remain significantly high.

Original languageEnglish (US)
Pages (from-to)261-267
Number of pages7
JournalAmerican Journal of Cardiology
Volume122
Issue number2
DOIs
StatePublished - Jul 15 2018
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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