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Racial Disparities and Outcomes After Left Ventricular Assist Device Implantation as Bridge to Transplantation or Destination Therapy
- Source :
- Innovations (Philadelphia, Pa.). 14(3)
- Publication Year :
- 2019
-
Abstract
- Objective We sought to investigate outcomes after left ventricular assist device (LVAD) implantation in advanced heart failure patients stratified by race. Methods Patients who had LVADs inserted at a single center as a bridge to transplant (BTT) or destination therapy (DT) were divided into 3 groups based on race: Caucasian, African American (AA), and Hispanic. Postoperative outcomes including complications, discharge disposition, and survival at defined time points were compared. Cox proportional hazards were used to identify factors associated with 1-year all-cause survival. Results A total of 158 patients who had LVADs as BTT ( n = 63) and DT ( n = 95) were studied. Of these, 56% ( n = 89) were Caucasians, 35% ( n = 55) were AA, and 9% ( n = 14) were Hispanics. AA patients had higher BMI and lower socioeconomic status and educational level, and were more likely to be single or divorced. Operative outcomes were similar among all 3 groups. Unadjusted 30-day, 6-month, 1-year, and 2-year survival rates for Caucasians versus AA versus Hispanics were 82% versus 89% versus 93%, P = 0.339; 74% versus 80% versus 71%, P = 0.596; 67% versus 76% versus 71%, P = 0.511; and 56% versus 62% versus 68%, P = 0.797. On multivariate analysis, device-related infection, malfunction, and abnormal rhythm were factors associated with overall all-cause mortality. Conclusion AA patients who undergo LVAD implantation as BTT or DT have lower socioeconomic status and educational level compared to their Caucasian or Hispanic counterparts. These differences, however, do not translate into postimplant survival outcomes.
- Subjects :
- Pulmonary and Respiratory Medicine
Adult
Male
medicine.medical_specialty
Prosthesis-Related Infections
medicine.medical_treatment
030204 cardiovascular system & hematology
White People
Body Mass Index
Prosthesis Implantation
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Internal medicine
Outcome Assessment, Health Care
medicine
Humans
Mortality
Aged
Proportional Hazards Models
Retrospective Studies
African american
Heart Failure
business.industry
Arrhythmias, Cardiac
General Medicine
Health Status Disparities
Hispanic or Latino
Middle Aged
medicine.disease
Prosthesis Failure
Black or African American
Survival Rate
030228 respiratory system
Social Class
Ventricular assist device
Heart failure
Cardiology
Educational Status
Surgery
Bridge to transplantation
Female
Heart-Assist Devices
Cardiology and Cardiovascular Medicine
business
Destination therapy
Subjects
Details
- ISSN :
- 15590879
- Volume :
- 14
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Innovations (Philadelphia, Pa.)
- Accession number :
- edsair.doi.dedup.....488bb8d8961627c1151cb78dfdfb0e9b