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High Mortality Rate in ESRD Patients after LVAD Placement

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Dr Ramesh Hotchandani    26 December 2017

Renal failure is a leading predictor of poor prognosis after cardiac surgery. In a cohort of Medicare beneficiaries, only about 48.4% of patients with end-stage renal disease (ESRD) survived to discharge after LVAD placement, with a median time to death of only 16 days. Compared to this, 96% of patients without ESRD survived to discharge after pump surgery, and their median survival was nearly 6 years (2125 days). The findings were published online in JAMA Internal Medicine.

The analysis included 155 patients identified in the US Renal Data System (USRDS), a national registry for ESRD, linked to Medicare claims for a first LVAD placement from 2003 to 2013 and 261 patients without ESRD identified from the 5% Medicare sample who received an LVAD during the same time period.

ESRD patients were more likely black as compared to those without ESRD (37.4% vs. 20.3%) and had more comorbidities (9 vs. 6). Their mean ages were 58.4 and 62.2 years, respectively.

The analysis revealed that one year after LVAD placement, 75.2% of the 155 patients with ESRD had died compared to 20.1% of the 261 patients without ESRD.

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