Racial Differences in Clinical Characteristics and Risk of Readmissions among Left Ventricular Assist Device Patients

• Published in: The Journal of heart and lung transplantation Vol. 39; no. 4; p. S333
• Main Authors: Sherazi, S., Shah, S., Younis, A., McNitt, S., Polonsky, B., Kutyifa, V., Alexis, J., Gosev, I., Vidula, H., Goldenberg, I.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.04.2020
• ISSN: 1053-2498; 1557-3117
• DOI: 10.1016/j.healun.2020.01.358

The purpose of this study was to compare clinical characteristics and risk of readmissions by race among patients with left ventricular assist device (LVAD). The study population included 349 patients implanted with LVADs at the University of Rochester Medical Center, NY from May 5, 2008 to September 19, 2018. Patients were stratified by race as White (N=304 [87%]) and Black (N=45 [13%]). The Anderson-Gill recurrent regression analysis was used to assess the independent association between race and recurrent readmissions during an average follow-up of 2.49 ± 2.19 years. Black patients displayed significant differences in the baseline clinical characteristics prior to LVAD implantation compared to White patients (Table 1), including a younger age and a lower frequency of ischemic etiology (10 (22%) vs 176 (58%), and a higher baseline serum creatinine. Kaplan-Meier survival analysis showed that mortality rates at 2- years of follow-up were non-significantly lower among Black patients as compared with White patients (14% vs. 25%, respectively; log-rank p-value = 0.163 for the overall difference). However, after multivariate adjustment, Black patients were shown to experience a significant 41% increased risk for recurrent admission after LVAD implantation (Hazard ratio 1.41, 95% CI; 1.05-1.90, p 0.022). Black patient were younger than White patient with LVAD but remain at higher risk of readmissions following LVAD implant. These findings suggest the need for careful follow-up with appropriate interventions to reduce readmissions in Black patients who undergo LVAD implantation.