loading page

Comparison of Household Income In In-Hospital Outcomes After Implantation of Left Ventricular Assist Device
  • +6
  • Bertrand Ebner,
  • Morgan Karetnick,
  • Jelani Grant,
  • Louis Vincent ,
  • Jennifer Maning,
  • Neal Olarte,
  • Odunayo Olorunfemi,
  • Rosario Colombo,
  • Sandra Chaparro
Bertrand Ebner
University of Miami Miller School of Medicine
Author Profile
Morgan Karetnick
University of Miami Miller School of Medicine
Author Profile
Jelani Grant
Author Profile
Louis Vincent
University of Miami
Author Profile
Jennifer Maning
Jackson Memorial Hospital
Author Profile
Neal Olarte
University of Miami Miller School of Medicine
Author Profile
Odunayo Olorunfemi
University of Miami Miller School of Medicine
Author Profile
Rosario Colombo
Jackson Memorial Hospital
Author Profile
Sandra Chaparro
Baptist Health South Florida
Author Profile

Abstract

Introduction: Due to the inability to keep up with the demand for heart transplantation, there is an increased utilization of left ventricular assist devices (LVAD). However, paucity of data exists regarding the association of household income with in-hospital outcomes after LVAD implantation. Methods: Retrospective cohort study using the NIS to identify all patients ≥18 years who underwent LVAD implantation from 2011-2017. Statistical analysis was performed comparing low household income (≤50th percentile) and high income (>50th percentile). Results: A total of 25,503 patients underwent LVAD implantation. The low-income group represented 53% and the high-income group corresponded to 47% of the entire cohort. The low-income group was found to be younger (mean age 55 ±14 vs. 58 ±14 years), higher proportion of females (24% vs. 22%), and higher proportion of blacks (32% vs. 16%, p<0.001 for all). The low-income group was found to have higher prevalence of hypertension, chronic pulmonary disease, smoking, dyslipidemia, obesity and pulmonary hypertension (p<0.001 for all). However, the high-income cohort had higher rate of atrial tachyarrhythmias and end-stage renal disease (p<0.001). During hospitalization, patients in the high-income group had increased rates of ischemic stroke, acute kidney injury, acute coronary syndrome, bleeding and need of extracorporeal membrane oxygenation (p<0.001 for all). We found that the unadjusted mortality had an OR 1.30 (CI [1.21-1.41], p<0.001) and adjusted mortality of OR 1.14 (CI [1.05-1.23], p=0.002). Conclusion: In patients undergoing LVAD implantation nationwide, low-income was associated with increased comorbidity burden, younger age, and fewer in-hospital complications and all-cause mortality.