Epidemiology and outcomes associated with anemia during long-term support with continuous-flow left ventricular assist devices

Abstract

Background: The purpose of this study was to define the prevalence and clinical ramifications of anemia in patients implanted with a continuous-flow left ventricular assist device (CF-LVAD).

Methods and results: Patients implanted with a CF-LVAD from January 1, 2008, to April 30, 2012, were included in this retrospective cohort study. The primary outcome was the prevalence of anemia throughout the 1st year of device support. Secondary end points included the impact of anemia on rates of readmission to hospital and mortality. Ninety-one patients were included; the prevalence of anemia 360 days after implantation was significantly reduced compared with baseline (61.4% vs 79.1%, respectively; P = .032); 65.4% of anemic patients and 34.6% of nonanemic patients were readmitted at least once (P = .067). The median number of readmissions in the anemic compared with the nonanemic group was 4 (interquartile range [IQR] 2-6) versus 1.5 (IQR 1-3), respectively (P < .001). Furthermore, among those who experienced >3 readmissions during the 1st year, 19 were anemic compared with 1 patient who was not anemic (P < .001).

Conclusions: Anemia remains a prevalent condition while on CF-LVAD support and is associated with a significant increase in the number of hospital readmissions.

Keywords: Anemia; left ventricular assist device; readmission.