LVAD Implantation Complicated by Sepsis: A Systematic Review
Presented During: Welcome Reception and Poster Competition | Sponsored by: TransMedics
University of Florida
Osaka, ON
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I am a second year medical student at the University of Florida College of Medicine. I am originally from Alexandria, Virginia and completed my undergraduate degree in Biomedical Science from the University of Central Florida. My current interest is in cardiovascular medicine, specifically in heart failure and cardio-obstetrics.
Friday, September 20, 2024: 5:00 PM - 6:30 PM
Omni King Edward Hotel
Description
OBJECTIVE: Sepsis incidence in patients with left ventricular assist devices (LVADs) is known to be associated with worse clinical outcomes. The incidence and outcomes of sepsis during index implantation of LVADs, however, is lacking examination in literature. We sought to conduct a systematic review to assess the current known incidence of sepsis during index implantation and its outcomes.
METHODS: Using the PubMed, CINAHL, and Embase databases, we conducted a thorough search for studies that investigated infections and sepsis incidence in patients undergoing LVAD implantation from inception until March 2024. From these studies, we extracted the patient demographics, adverse outcomes of interest, and study characteristics. Our outcomes of interest included incidence of LVAD implantation complicated by sepsis, implant mortality related to sepsis, implant length of stay (iLOS), and 1-year survival.
RESULTS: From a retrieved total of 294 records, 9 studies met the final inclusion criteria to be included in the review, with a total of 24,795 patients. No studies reported on all 4 outcomes of interest. 89% of the studies reported the incidence of sepsis during index LVAD implantation hospitalization, with an incidence ranging from 3% - 60%. 22% studies commented on sepsis related mortality, with 1 reporting a 35.4% in-hospital mortality in those patients in whom LVAD implantation was complicated by sepsis. 1 study reported iLOS to be prolonged in those patients with sepsis versus those whose implant was not complicated by sepsis (43.8 vs 26.4 days). No studies commented on the relationship between sepsis and 1-year survival.
CONCLUSIONS: Outcomes of interest and its definitions varied widely between the studies, thus necessitating a narrative synthesis of the included studies. Narrative synthesis showed that sepsis incidence during index implantation is widely variable, more likely associated with higher rates of implant mortality and increased LOS. Due to the limited data currently available on index LVAD implantation related sepsis and its clinical outcomes, standardization of data collection and reporting metrics to guide additional research is needed to optimize outcomes.
Authors
Sarah Allbright (1), Parth Patel (2), Mustafa Ahmed (3)
Institutions
(1) University of Florida, Gainesville, FL, (2) University of Florida College of Medicine, Gainesville, FL, (3) University of Florida Health, Gainesville, FL
METHODS: Using the PubMed, CINAHL, and Embase databases, we conducted a thorough search for studies that investigated infections and sepsis incidence in patients undergoing LVAD implantation from inception until March 2024. From these studies, we extracted the patient demographics, adverse outcomes of interest, and study characteristics. Our outcomes of interest included incidence of LVAD implantation complicated by sepsis, implant mortality related to sepsis, implant length of stay (iLOS), and 1-year survival.
RESULTS: From a retrieved total of 294 records, 9 studies met the final inclusion criteria to be included in the review, with a total of 24,795 patients. No studies reported on all 4 outcomes of interest. 89% of the studies reported the incidence of sepsis during index LVAD implantation hospitalization, with an incidence ranging from 3% - 60%. 22% studies commented on sepsis related mortality, with 1 reporting a 35.4% in-hospital mortality in those patients in whom LVAD implantation was complicated by sepsis. 1 study reported iLOS to be prolonged in those patients with sepsis versus those whose implant was not complicated by sepsis (43.8 vs 26.4 days). No studies commented on the relationship between sepsis and 1-year survival.
CONCLUSIONS: Outcomes of interest and its definitions varied widely between the studies, thus necessitating a narrative synthesis of the included studies. Narrative synthesis showed that sepsis incidence during index implantation is widely variable, more likely associated with higher rates of implant mortality and increased LOS. Due to the limited data currently available on index LVAD implantation related sepsis and its clinical outcomes, standardization of data collection and reporting metrics to guide additional research is needed to optimize outcomes.
Authors
Sarah Allbright (1), Parth Patel (2), Mustafa Ahmed (3)
Institutions
(1) University of Florida, Gainesville, FL, (2) University of Florida College of Medicine, Gainesville, FL, (3) University of Florida Health, Gainesville, FL