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Multicenter Study
. 2018 Jul 15;122(2):261-267.
doi: 10.1016/j.amjcard.2018.03.363. Epub 2018 Apr 11.

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

Shanti Patel  1 , Priti Poojary  2 , Sumeet Pawar  3 , Aparna Saha  2 , Achint Patel  4 , Kinsuk Chauhan  2 , Ashish Correa  5 , Pratik Mondal  6 , Kanika Mahajan  2 , Lili Chan  2 , Rocco Ferrandino  2 , Dhruv Mehta  6 , Shiv Kumar Agarwal  4 , Narender Annapureddy  7 , Jignesh Patel  8 , Paul Saunders  9 , Gregory Crooke  9 , Jacob Shani  10 , Tariq Ahmad  11 , Nihar Desai  12 , Girish N Nadkarni  2 , Vijay Shetty  10
Affiliations
Multicenter Study

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

Shanti Patel et al. Am J Cardiol. .

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.

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Conflict of interest statement

Conflicts of Interest Disclosure:

All authors have approved the final article. Dr. Desai is supported by grant K12 HS023000–01 from the Agency for Healthcare Research and Quality. Dr. Desai receives research funding from the Centers for Medicare & Medicaid Services to develop and maintain performance measures that are used for public reporting and support from Johnson & Johnson and Medtronic, through Yale University, to develop methods of clinical trial data sharing.

Figures

Figure 1:
Figure 1:
Bar chart demonstrating the percentage of readmissions due to each reason for readmission in different time intervals after discharge from index hospitalization for LVAD implantation in 2013.
See this image and copyright information in PMC

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