Predictors of Failure to Rescue After Left Ventricular Assist Device Implantation

PurposeFailure to rescue (FTR), defined as death after a complication, is an established hospital quality metric for coronary and valve surgery. While prior work has documented interhospital variability in FTR durable left ventricular assist device (LVAD), less known about patient complication-specific predictors of this setting.MethodsPatients undergoing primary LVAD implantation from 2012-2017 were selected the INTERMACS database. The cohort was divided into two groups compared based on survival following complications FTR. in-hospital mortality experiencing at least one major complications: severe right heart failure, respiratory renal failure requiring dialysis, infection, malfunction, bleeding reoperation. Multivariable logistic regression used evaluate both pre-operative complication specific Stepwise selection arrive final model.ResultsOf 13,617 patients sample, 4,839 (35.5%) experienced which 854 (17.6%) died (i.e., FTR). Patients group more likely be older (61.3 +/- 11.5 vs 56.9 +/-12.9, p<0.001), Profile 1 (30.9% 20.9%, p<0.0001), Destination Therapy (55.6% 48.3%, p=0.0003). Significant included: history CABG (OR = 1.54, CI95%: 1.31-1.82), surgery 1.50, 1.07-2.11), preoperative dialysis 2.29, 1.70-3.08) ECMO (OR=4.27, 3.01-6.04). developing had highest rate (75.3%) followed by reintubation (45.1%), Table 1.ConclusionThis study identified four significant placement. Future should focus identifying risk FTR, well early recognition management complications. Failure setting. model. Of 1. This