This article is more than 5 years old. Information may no longer be current.
Hospital readmission frequent after continuous flow pump therapy
The incidence of unplanned hospital readmissions for a variety of reasons appears to be high after implantation of ventricular assist devices, researchers reported.
“The rapid increase of implantation of ventricular assist devices since their approval for destination therapy in January 2010 has also seen with it a large number of post-implant readmissions,” Shelley A. Hall, MD, director of heart transplant services at Baylor University Medical Center, and colleagues wrote in an abstract.
Shelley A. Hall
To assess the scale of this problem, the researchers conducted a retrospective chart review on all patients receiving continuous flow pump. From September 2008 to March 2012, 85 patients received univentricular assist device therapy in the form of a continuous flow pump — 80 of whom were successfully discharged from the hospital. Of these patients, 57 required unplanned readmissions, with a rate of 2.6 readmissions per patient.
Results revealed that, among patients readmitted to the hospital, ventricular assist device (VAD)-related causes were nearly twice as common as non-VAD-related causes (98 vs. 52). These included gastrointestinal bleeding (n=53); VAD-patient interactions (n=14); device-associated infections (pump, n=7; driveline, n=6); intracranial hemorrhages (n=5); epistaxis (n=5); thromboembolic strokes (n=3); and other (n=4).
Non-device-related causes commonly included progression of cardiac disease (n=8), neurological or psychiatric complaints (n=8), and infections (n=7). Less common non-device-related causes also included urgent gastrointestinal surgical procedures (n=5); volume overload (n=4); a management of comorbidities (n=3); tachyarrhythmias (n=2); trauma (n=2); noncardiac chest pain (n=2); and gynecological emergencies (n=2).
“In our practice, unplanned readmissions following continuous flow pump therapy are common,” the researchers wrote. “Efforts addressing outpatient management of anticoagulation and patient comorbidities may significantly impact unplanned hospital readmissions in patient supported with continuous flow pumps.”
For more information:
Hall S. Abstract #115. Presented at: the Heart Failure Society of America 16th Annual Scientific Meeting; Sept. 9-12, 2012; Seattle.
Disclosure: Hall works at a research site for trials sponsored by Thoratec, but reports no financial reimbursements.