PMID- 20580265
OWN - NLM
STAT- MEDLINE
DCOM- 20101230
LR  - 20211020
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Print)
IS  - 1053-2498 (Linking)
VI  - 29
IP  - 9
DP  - 2010 Sep
TI  - Early adverse events as predictors of 1-year mortality during mechanical 
      circulatory support.
PG  - 981-8
LID - 10.1016/j.healun.2010.04.014 [doi]
AB  - BACKGROUND: Ventricular assist devices (VADs) provide effective treatment for 
      end-stage heart failure; however, most patients experience > or =1 major adverse 
      events (AEs) while on VAD support. Although early, non-fatal AEs may increase the 
      risk of later death during VAD support, this relationship has not been 
      established. Therefore, we sought to determine the impact on 1-year mortality of 
      AEs occurring during the first 60 days of VAD support. METHODS: A retrospective 
      analysis was performed using prospectively collected data from a single-site 
      database for patients aged > or =18 years receiving left ventricular or 
      biventricular support during 1996 to 2008 and who survived >60 days on VAD 
      support. Fourteen major classes of AEs occurring during this 60-day period were 
      examined. One-year survival rates of patients with and without each major AE were 
      compared. RESULTS: The study included 163 patients (80% men; mean age, 49.5 
      years), of whom 87% were European American, 72% had left ventricular support, and 
      83% were bridge to transplant. The occurrence of renal failure, respiratory 
      failure, bleeding events, and reoperations during the first 60 days after 
      implantation significantly increased the risk of 1-year mortality. After 
      controlling for gender, age, VAD type, and intention to treat, renal failure was 
      the only major AE significantly associated with later mortality (hazard ratio, 
      2.96; p = .023). CONCLUSIONS: Specific AEs, including renal failure, respiratory 
      and bleeding events, and reoperations, significantly decrease longer-term 
      survival. Renal failure conferred a 3-fold increased risk of 1-year mortality. 
      Peri-operative management should focus on strategies to mitigate risk for renal 
      failure in order to maximize later outcomes.
CI  - Copyright 2010 International Society for Heart and Lung Transplantation. 
      Published by Elsevier Inc. All rights reserved.
FAU - Genovese, Elizabeth A
AU  - Genovese EA
AD  - Artificial Heart Program, University of Pittsburgh Medical Center, Pittsburgh, 
      Pennsylvania, USA.
FAU - Dew, Mary Amanda
AU  - Dew MA
FAU - Teuteberg, Jeffrey J
AU  - Teuteberg JJ
FAU - Simon, Marc A
AU  - Simon MA
FAU - Bhama, Jay K
AU  - Bhama JK
FAU - Bermudez, Christian A
AU  - Bermudez CA
FAU - Lockard, Kathleen L
AU  - Lockard KL
FAU - Winowich, Steve
AU  - Winowich S
FAU - Kormos, Robert L
AU  - Kormos RL
LA  - eng
GR  - TL1 TR000145/TR/NCATS NIH HHS/United States
GR  - TL1 RR024155-04/RR/NCRR NIH HHS/United States
GR  - UL1 RR024153-04/RR/NCRR NIH HHS/United States
GR  - UL1 TR000005/TR/NCATS NIH HHS/United States
GR  - R01 MH072718/MH/NIMH NIH HHS/United States
GR  - TL1 RR024155/RR/NCRR NIH HHS/United States
GR  - T32 5TL1 RR024155-04/RR/NCRR NIH HHS/United States
GR  - UL1 RR024153/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20100701
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cohort Studies
MH  - Equipment Design
MH  - Female
MH  - Heart Failure/mortality/*surgery
MH  - Heart Transplantation/mortality/statistics & numerical data
MH  - *Heart-Assist Devices/adverse effects
MH  - Hemorrhage/etiology
MH  - Humans
MH  - Infections/etiology
MH  - Kidney Diseases/etiology
MH  - Male
MH  - Middle Aged
MH  - Respiratory Tract Diseases/etiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
MH  - Treatment Failure
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC2926204
MID - NIHMS204321
EDAT- 2010/06/29 06:00
MHDA- 2010/12/31 06:00
PMCR- 2011/09/01
CRDT- 2010/06/29 06:00
PHST- 2010/03/01 00:00 [received]
PHST- 2010/04/15 00:00 [revised]
PHST- 2010/04/28 00:00 [accepted]
PHST- 2010/06/29 06:00 [entrez]
PHST- 2010/06/29 06:00 [pubmed]
PHST- 2010/12/31 06:00 [medline]
PHST- 2011/09/01 00:00 [pmc-release]
AID - S1053-2498(10)00271-8 [pii]
AID - 10.1016/j.healun.2010.04.014 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2010 Sep;29(9):981-8. doi: 10.1016/j.healun.2010.04.014. 
      Epub 2010 Jul 1.