Copyright
©The Author(s) 2017.
World J Cardiol. Feb 26, 2017; 9(2): 154-161
Published online Feb 26, 2017. doi: 10.4330/wjc.v9.i2.154
Published online Feb 26, 2017. doi: 10.4330/wjc.v9.i2.154
Table 1 Baseline demographics for patients who waited 0-7 d, 8-31 d, 32-65 d, and ≥ 66 d for an orthotopic heart transplant after left ventricular assist device implantation
| 0-7 d (n = 41) | 8-31 d (n = 38) | 32-65 d (n = 42) | ≥ 66 d (n = 43) | No OHT (n = 2036) | |
| Length of stay, mean ± SD | 39.3 ± 33.2 | 48.9 ± 25.6 | 85.8 ± 40.1 | 151.2 ± 52.6 | 37.1 ± 34.6 |
| Length of stay after OHT, mean ± SD | 23.8 ± 21.4 | 21.7 ± 15.8 | 27.6 ± 37.1 | 27.1 ± 22.8 | NA |
| Mortality, n (%) | 11 (26.8) | 5 (13.2) | 5 (11.9) | 5 (11.6) | 564 (27.3) |
| Age, mean ± SD | 50.6 ± 12.6 | 48.6 ± 12.7 | 47.4 ± 15.3 | 46.3 ± 13.1 | 55.4 ± 13.2 |
| Sex, n (%) | |||||
| Male | 33 (80.5) | 32 (84.2) | 35 (83.3) | 34 (79.1) | 1525 (74.9) |
| Female | 8 (19.5) | 6 (15.8) | 7 (16.7) | 9 (20.9) | 511 (25.1) |
| Race, n (%) | |||||
| White | 25 (61.0) | 19 (50.0) | 23 (54.8) | 22 (51.2) | 1185 (58.2) |
| Black | 3 (7.3) | 5 (13.2) | 8 (19.0) | 6 (14.0) | 330 (16.2) |
| Hispanic | 3 (7.3) | 7 (18.4) | 2 (4.8) | 5 (11.6) | 125 (6.1) |
| Asian/Pacific Islander | 2 (4.9) | 0 (0.0) | 1 (2.4) | 4 (9.3) | 44 (2.2) |
| Native American | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 5 (0.2) |
| Other or unknown | 8 (19.5) | 7 (18.4) | 8 (19.0) | 6 (14.0) | 347 (17.0) |
| Median household income, n (%) | |||||
| $1-24999 | 4 (9.8) | 8 (21.1) | 8 (19.0) | 8 (18.6) | 447 (22.0) |
| $25000-34999 | 10 (24.4) | 10 (26.3) | 10 (23.8) | 7 (16.3) | 454 (22.3) |
| $35000-44999 | 12 (29.3) | 8 (21.1) | 10 (23.8) | 13 (30.2) | 509 (25.0) |
| $45000 or more | 129 (29.3) | 12 (31.6) | 14 (33.3) | 14 (32.6) | 579 (28.4) |
| Unknown | 3 (7.3) | 0 (0.0) | 0 (0.0) | 1 (2.3) | 47 (2.3) |
| Comorbidities | |||||
| Diabetes | 8 (19.5) | 5 (13.2) | 4 (9.5) | 2 (4.7) | 373 (18.3) |
| Hyperlipidemia | 5 (12.2) | 2 (5.3) | 3 (7.1) | 3 (7.0) | 297 (14.6) |
| Hypertension | 5 (12.2) | 1 (2.6) | 2 (4.8) | 2 (4.7) | 291 (14.3) |
| History of smoking | 5 (12.2) | 2 (5.3) | 0 (0.0) | 0 (0.0) | 137 (6.7) |
| BMI ≥ 30 kg/m2 | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 96 (4.7) |
| No. of comorbid diagnoses, mean ± SD | 11.9 ± 3.1 | 12.3 ± 3.0 | 12.5 ± 3.2 | 12.5 ± 3.2 | 12.8 ± 2.9 |
| Location of hospital, n (%) | |||||
| Rural | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 17 (0.8) |
| Urban | 41 (100.0) | 38 (100.0) | 42 (100.0) | 43 (100.0) | 2017 (99.1) |
| Unknown | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (0.1) |
| Size of hospital, n (%) | |||||
| Small | 4 (9.8) | 0 (0.0) | 0 (0.0) | 2 (4.7) | 32 (1.6) |
| Medium | 7 (17.0) | 6 (15.8) | 5 (11.9) | 0 (0.0) | 211 (10.4) |
| Large | 30 (73.2) | 32 (84.2) | 37 (88.1) | 41 (95.3) | 1791 (88.0) |
| Unknown | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (0.1) |
| Teaching status of hospital, n (%) | |||||
| Nonteaching | 1 (2.4) | 1 (2.6) | 2 (4.8) | 1 (2.3) | 160 (7.9) |
| Teaching | 40 (97.6) | 37 (97.4) | 40 (95.2) | 42 (97.7) | 1874 (92.0) |
| Unknown | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (0.1) |
Table 2 Complications in hospitalized patients with or without same admission orthotopic heart transplant after left ventricular assist device
| Early OHT (n = 41) | Late OHT (n = 123) | OHT- (n = 2036) | Total (n = 2200) | |
| Acute renal failure | 24 (58.5) | 64 (52.0) | 963 (47.3) | 1051 (47.8) |
| Reoperation | 28 (68.3) | 87 (70.7) | 803 (39.4) | 918 (41.7) |
| Bleeding requiring transfusion | 7 (17.1) | 30 (24.4) | 780 (38.3) | 817 (37.1) |
| Acute respiratory failure | 8 (19.5) | 37 (30.1) | 518 (25.4) | 563 (25.6) |
| Sepsis | 2 (4.9) | 17 (13.8) | 233 (11.4) | 252 (11.5) |
| Postoperative cardiac complication | 7 (17.1) | 15 (12.2) | 234 (11.5) | 256 (11.6) |
| Acute liver failure | 3 (7.3) | 9 (7.3) | 224 (11.0) | 236 (10.7) |
| Device failure | 0 (0.0) | 4 (3.3) | 62 (3.0) | 66 (3.0) |
| Stroke | 1 (2.4) | 1 (0.8) | 53 (2.6) | 55 (2.5) |
Table 3 Baseline demographics of all left ventricular assist device patients, left ventricular assist device patients from 1998-2005 (pulsatile-flow era), and left ventricular assist device patients from 2006-2011 (continuous-flow era)
| All LVADs (n = 2200) | 1998-2005 (n = 589) | 2006-2011 (n = 1611) | P-valuea | |
| Mortality, n (%) | 590 (26.5) | 253 (43.0) | 329 (20.4) | < 0.001 |
| Same admission OHT, n (%) | 164 (7.5) | 102 (17.3) | 62 (3.8) | < 0.001 |
| Early same admission OHT, n (%) | 41 (25.0) | 22 (21.6) | 19 (30.6) | 0.373 |
| Early same admission OHT mortality, n (%) | 11 (26.8) | 8 (36.4) | 3 (15.8) | 0.319 |
| Length of stay after early OHT, mean ± SD | 23.8 ± 21.4 | 30.9 ± 26.0 | 17.6 ± 14.3 | 0.054 |
| Late same admission OHT, n (%) | 123 (75.0) | 80 (78.4) | 43 (69.4) | 0.849 |
| Late same admission OHT mortality, n (%) | 15 (12.2) | 11 (13.8) | 4 (9.3) | 0.774 |
| Length of stay after late OHT, mean ± SD | 25.6 ± 26.9 | 26.1 ± 22.9 | 25.4 ± 29.0 | 0.883 |
| Length of stay, mean ± SD | 40.5 ± 38.9 | 44.7 ± 48.6 | 39.0 ± 34.6 | 0.008 |
| Age, mean ± SD | 53.4 ± 13.7 | 53.2 ± 13.4 | 55.4 ± 13.4 | < 0.001 |
| Sex, n (%) | ||||
| Male | 1659 (75.4) | 433 (73.5) | 1226 (76.1) | 0.23 |
| Female | 541 (24.6) | 156 (26.5) | 385 (23.9) | |
| Race, n (%) | < 0.001 | |||
| White | 1274 (57.9) | 327 (55.5) | 947 (58.8) | |
| Black | 352 (16.0) | 62 (10.5) | 290 (18.0) | |
| Hispanic | 142 (6.5) | 28 (4.8) | 114 (7.1) | |
| Asian/Pacific Islander | 51 (2.3) | 13 (2.2) | 38 (2.4) | |
| Native American | 5 (0.2) | 1 (0.2) | 4 (0.2) | |
| Other or unknown | 376 (17.1) | 143 (24.3) | 148 (9.2) | |
| Median household income, n (%) | < 0.001 | |||
| $1-24999 | 475 (21.6) | 88 (14.9) | 387 (24.0) | |
| $25000-34999 | 491 (22.3) | 126 (21.4) | 365 (22.7) | |
| $35000-44999 | 552 (25.1) | 141 (23.9) | 411 (25.5) | |
| $45000 or more | 631 (28.7) | 214 (36.3) | 417 (25.9) | |
| Unknown | 51 (2.3) | 20 (3.4) | 31 (2.4) | |
| Comorbidities | ||||
| Diabetes | 391 (17.8) | 91 (15.4) | 300 (18.6) | 0.097 |
| Hyperlipidemia | 310 (14.1) | 61 (10.4) | 249 (15.5) | 0.003 |
| Hypertension | 309 (14.0) | 88 (14.9) | 221 (13.7) | 0.508 |
| History of smoking | 131 (6.0) | 29 (4.9) | 102 (6.3) | 0.257 |
| BMI ≥ 30 kg/m2 | 96 (4.4) | 12 (2.0) | 84 (5.2) | 0.002 |
| No. of comorbid diagnosis, mean ± SD | 12.7 ± 2.9 | 10.6 ± 2.9 | 13.5 ± 2.5 | < 0.001 |
| Location of hospital, n (%) | 0.73 | |||
| Rural | 17 (0.8) | 5 (0.8) | 12 (0.7) | |
| Urban | 2181 (99.1) | 583 (99.0) | 1598 (99.2) | |
| Unknown | 2 (0.1) | 1 (0.2) | 1 (0.1) | |
| Size of hospital, n (%) | 0.002 | |||
| Small | 38 (1.7) | 20 (3.4) | 18 (1.1) | |
| Medium | 229 (10.4) | 67 (11.4) | 162 (10.1) | |
| Large | 1931 (87.8) | 501 (85.1) | 1430 (88.8) | |
| Unknown | 2 (0.1) | 1 (0.2) | 1 (0.1) | |
| Teaching status of hospital, n (%) | < 0.001 | |||
| Nonteaching | 165 (7.5) | 75 (12.7) | 90 (5.6) | |
| Teaching | 2033 (92.4) | 513 (87.1) | 1520 (94.4) | |
| Unknown | 2 (0.1) | 1 (0.2) | 1 (0.1) |
Table 4 A generalized multivariate linear model to evaluate post-left ventricular assist device orthotopic heart transplant mortality (positive estimates reflect positive association with increased mortality)
| Regression coefficient | Standard error | P-value | |
| Age | 0.003 | 0.002 | 0.158 |
| Female sex | 0.071 | 0.075 | 0.342 |
| Caucasian race | -0.01 | 0.027 | 0.695 |
| Median household income | 0.013 | 0.027 | 0.638 |
| Number of comorbidities | 0.006 | 0.010 | 0.518 |
| Years 1998-2005 | 0.096 | 0.060 | 0.113 |
| Early OHT | 0.2 | 0.067 | 0.004a |
- Citation: Gulati G, Ouyang D, Ha R, Banerjee D. Optimal timing of same-admission orthotopic heart transplantation after left ventricular assist device implantation. World J Cardiol 2017; 9(2): 154-161
- URL: https://www.wjgnet.com/1949-8462/full/v9/i2/154.htm
- DOI: https://dx.doi.org/10.4330/wjc.v9.i2.154