Abstract
Left ventricular assist device (LVAD) is considered a life-saving therapeutic option for patients with advanced refractory end stage heart failure. Peripheral arterial disease (PAD) can limit the quality of life and carry an increased risk of higher morbidity and mortality.
We aim to study the in-hospital outcomes among patients with documented PAD undergoing LVAD surgery by using weighted data from the National Inpatient Sample (NIS) database between years 2002-2014.
We identified all patients older than 18 years who underwent LVAD insertion. LVAD patients with PAD diagnosis were compared to LVAD patients without PAD. Univariate and multivariate logistic regression analysis were performed for the primary outcome of in-hospital mortality and multiple secondary outcomes.
A total of 20,817 patients with LVAD insertion were included in our study. Out of 20,817 patients, 1,625 patients (7.8%) had PAD at the time of LVAD insertion. PAD patients had higher in-hospital mortality rates compared with non-PAD group (16.7% vs 12.8% aOR 1.291; 95% CI, 1.071-1.555, P=0.007), with increased incidence of infections, acute renal failure, major bleeding, vascular and implantation-related complications. Overall, PAD patients who received LVAD were at increased risk for in-hospital mortality and morbidity compared to those without PAD.
Screening for PAD prior to LVAD implantation should be reemphasized as the current recommendation.