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Tipo de Documento:	Artigo
Título :	Trends in left ventricular assist device use and outcomes among Medicare beneficiaries, 2004–2011
Autor :	Lampropulos, Julianna F. Kim, Nancy Wang, Yun Desai, Mayur M. Barreto Filho, José Augusto Soares Dodson, John A. Dries, Daniel L. Mangi, Abeel A. Krumholz, Harlan M.
Fecha de publicación :	2014
Resumen:	Objective: To characterise the trends in the left ventricular assist device (LVAD) implantation rates and outcomes between 2004 and 2011 in the Medicare population. Since the approval of the HeartMate II in 2008, the use of LVADs has steadily climbed. Given the increase in LVAD use, issues around discharge disposition, post-implant hospitalisations and costs require further understanding. Methods: We examined LVAD implantation rates and short-term and long-term outcomes among Medicare fee-for-service beneficiaries hospitalised for LVAD implantation. We also conducted analyses among survivors 1-year post-discharge to examine rehospitalisation rates. Lastly, we reported Centers for Medicare & Medicaid Services (CMS) payments for both index hospitalisation and rehospitalisations 1 year postdischarge. Results: A total of 2152 LVAD implantations were performed with numbers increasing from 107 in 2004 to 612 in 2011. The 30-day mortality rate decreased from 52% to 9%, and 1-year mortality rate decreased from 69% to 31%. We observed no change in overall length of stay, but post-procedure length of stay increased. We also found an increase in home discharge dispositions from 26% to 53%. Between 2004 and 2010, the rehospitalisation rate increased and the number of hospital days decreased. The adjusted CMS payment for the index hospitalisation increased from $188 789 to $225 697 over time but decreased for rehospitalisation from $60 647 to $53 630. Conclusions: LVAD implantations increased over time. We found decreasing 30-day and 1-year mortality rates and increasing home discharge disposition. The proportion of patients rehospitalised among 1-year survivors remained high with increasing index hospitalisation cost, but decreasing post-implantation costs over time.
Palabras clave :	Left ventricular assist device Medicare Implantation trends
ISSN :	2053-3624
Es parte de:	Open heart
Idioma :	eng
Institución / Editorial :	BMJ Publishing Group Ltd
Citación :	LAMPROULOS, J. F. et al. Trends in left ventricular assist device use and outcomes among Medicare beneficiaries, 2004–2011. Open heart, London, v. 1, n. 1, 2014. Disponível em: https://openheart.bmj.com/content/1/1/e000109. Acesso em: 28 jan. 2026.
License:	Creative Commons Atribuição-NãoComercial 3.0 Não Adaptada (CC BY-NC 3.0)
URI :	https://ri.ufs.br/jspui/handle/riufs/24431
Aparece en las colecciones:	DME - Artigos de periódicos

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