Improved outcomes seen with ventricular assist devices
(HealthDay)—Among Medicare patients receiving implantation of ventricular assist devices (VADs) for advanced heart failure, mortality has decreased, but readmission rates did not change, according to research published online Jan. 29 in the Journal of the American College of Cardiology.
Prateeti Khazanie, M.D., M.P.H., of Duke University in Durham, N.C., and colleagues retrospectively analyzed data for all Medicare fee-for-service patients who received an implantable VAD between 2006 and 2011 (2,507 patients) to examine trends in mortality and readmission rates.
The researchers found that, during the study period, in-hospital mortality decreased from 30 to 10 percent (P < 0.001), one-year mortality decreased from 42 to 26 percent (P < 0.001), and all-cause readmission rate remained frequent, with a slight change from 82 to 81 percent (P = 0.70). These patterns persisted after covariate adjustment. Low procedure volume was associated with increased risks for in-hospital mortality (risk ratio, 1.72; 95 percent confidence interval [CI], 1.28 to 2.33) and one-year mortality (risk ratio, 1.55; 95 percent CI, 1.24 to 1.93) but not readmission.
"Short-term and long-term mortality after VAD implantation among Medicare beneficiaries improved, but readmission remained common," the authors write. "Higher volume of VAD implants was associated with lower risk of mortality but not readmission."
Two of the study authors disclosed financial ties to Thoratec.
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