NYMC Faculty Publications

Outcomes of Cardiac Arrest and Cardiopulmonary Resuscitation in Patients With Left Ventricular Assist Device; an Insight From a National Inpatient Sample

Authors

Kirolos Barssoum, Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA; Department of Internal Medicine, Unity Hospital, Rochester Regional Health System, Rochester, NY, USA. Electronic address: kiro11090@hotmail.com.
Harsh Patel, Department of Internal Medicine, Louis A Weiss Memorial Hospital, Chicago, IL, USA.Follow
Devesh Rai, Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA.
Ashish Kumar, Department of Internal Medicine, Cleveland Clinic Akron General, Akron, OH, USA.Follow
Mohab Hassib, St. Francis Medical Center, Trenton, NJ, USA.
Hasan F. Othman, Michigan State University/Sparrow Health System, Lansing, MI, USA.
Samarthkumar Thakkar, Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA.
Ahmed El Karyoni, Cardiovascular Department, Loyola University Medical Center, IL, USA.
Osarenren Idemudia, Department of Internal Medicine, Unity Hospital, Rochester Regional Health System, Rochester, NY, USA.
Fadi Ibrahim, American University of Antigua, Antigua and Barbuda.
Tala Salem, Department of Internal Medicine, Unity Hospital, Rochester Regional Health System, Rochester, NY, USA.
Mariam Shariff, Department of General Surgery, Mayo Clinic, Rochester, MN, USA.
Ahmad Jabri, Heart and Vascular Center, Case Western Reserve University/MetroHealth Medical Center, Cleveland, OH, USA.
Ayman ElBadawi, Department of Cardiovascular Medicine, University of Texas Medical Branch, Galveston, TX, USA; Department of Cardiovascular Medicine, Ain Shams University, Cairo, Egypt.
Soidjon Khodjaev, Department of Advanced Heart Failure and Transplant, Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA.
Dhrubajyoti Bandyopadhyay, Department of Cardiology, New York Medical College at Westchester Medical Center, New York, NY, USA.
Wilbert S. Aronow, Department of Cardiology, New York Medical College at Westchester Medical Center, New York, NY, USA.Follow
Vishal Parikh, Department of Advanced Heart Failure and Transplant, Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA.
Mohan Rao, Department of Cardiology, Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA.
Park Soon, Department of Advanced Heart Failure and Transplant, Sands-Constellation Heart Institute, Rochester Regional Health, Rochester, NY, USA.

Author Type(s)

Faculty, Resident/Fellow

DOI

10.1016/j.hlc.2021.05.096

Journal Title

Heart, Lung & Circulation

First Page

246

Last Page

254

Document Type

Article

Publication Date

2-1-2022

Department

Medicine

Abstract

BACKGROUND: Outcomes of patients with implanted left ventricular assist device (LVAD) implantation experiencing a cardiac arrest (CA) are not well reported. We aimed at defining the in-hospital outcomes of patients with implanted LVAD experiencing a CA. METHODS: The national inpatient sample (NIS) was queried using ICD9/ICD10 codes for patients older than 18 years with implanted LVAD and CA between 2010-2018. We excluded patients with orthotropic heart transplantation, biventricular assist device (BiVAD) implantation and do not resuscitate (DNR) status. RESULTS: A total of 93,153 hospitalisations between 2010 and 2018 with implanted LVAD were identified. Only 578 of these hospitalisations had experienced CA and of those, 173 (33%) hospitalisations underwent cardiopulmonary resuscitation (CPR). The mean age of hospitalisations that experienced a CA was 60.61±14.85 for non-survivors and 56.23±17.33 for survivors (p=0.14). The in-hospital mortality was 60.8% in hospitalisations with CA and 74.33% in hospitalisations in whom CPR was performed. In an analysis comparing survivors with non-survivors, non-survivors had more diabetes mellitus (DM) (p=0.01), and ischaemic heart disease (IHD) (p=0.04). Age, female sex, peripheral vascular disease and history of coronary artery bypass graft (CABG) were independently associated with increased mortality in our cohort. Also, ventricular tachycardia (VT) and CPR were independently associated with in-hospital mortality. During the study period, there was a significantly decreasing trend in performing CPR in LVAD hospitalisations with CA. CONCLUSION: In conclusion, age, female sex, peripheral vascular disease, history of CABG, VT and CPR were independently associated with in-hospital mortality in LVAD hospitalisations who experienced CA.

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