Evidence map›Paper›PMID 30579542›Full record

ArticleThe Journal of thoracic and cardiovascular surgery2019

In-hospital mortality in older patients after ventricular assist device implantation: A national cohort study.

Charlotta Lindvall, Brooks Udelsman, Devvrat Malhotra, Ethan Y Brovman, Richard D Urman, David A D'Alessandro, James A Tulsky

Abstract read
In one paragraph

Article in The Journal of thoracic and cardiovascular surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. The application of mechanical circulatory support in special conditions.European heart journal supplements : journal of the European Society of Cardiology · 2025
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Charlotta LindvallDepartment of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Mass; Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass. Electronic address: Charlotta_Lindvall@DFCI.harvard.edu.
Brooks UdelsmanDepartment of Surgery, Massachusetts General Hospital, Boston, Mass.
Devvrat MalhotraHarvard School of Public Health, Boston, Mass.
Ethan Y BrovmanDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Mass.
Richard D UrmanDepartment of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Mass.
David A D'AlessandroDivision of Cardiac Surgery, Massachusetts General Hospital, Boston, Mass.
James A TulskyDepartment of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Mass; Division of Palliative Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass.

Funding

Refinement and Expansion of the Palliative Care Research Cooperative Group (PCRC)U24NR014637 · NINR · DUKE UNIVERSITY · PI KUTNER, JEAN S, POLLAK, KATHRYN I · 2013 to 2017
$9.6M
Palliative Care Research Cooperative Group (PCRC): Refinement and ExpansionU2CNR014637 · NINR · UNIVERSITY OF COLORADO DENVER · PI COLBORN, KATHRYN LOUISE · 2018 to 2022
$8.6M
NINR NIH HHS U24 NR014637NINR NIH HHS U2C NR014637
6 · The paper itself

Abstract

objectivesTo assess baseline patient characteristics and identify factors associated with in-hospital mortality after ventricular assist device (VAD) placement.

methodsCross-sectional study using the National Inpatient Sample database from January 2010 to December 2014. Analyses were performed with sample weights provided by the National Inpatient Sample, which are reported ± the standard error of the mean.

resultsWeighted samples yielded 15,021 ± 1111 patients who received a VAD. The mean age at time of implantation was 56.6 years. Most recipients were white (59.9%) and male (75.0%). Among older patients, in-hospital mortality increased from 17.2% to 48.2% when 1 or more high-risk interventions (cardiac surgery, prolonged mechanical ventilation, hemodialysis, or extracorporeal membrane oxygenation) preceded VAD placement (P < .001). In comparison, in-hospital mortality in younger patients increased from 11.1% to 29.4% when 1 or more of these same procedures preceded VAD placement. The mortality difference associated with these procedures was 19% greater in older patients compared with younger patients (95% confidence interval [CI], 9%-28%). In-hospital mortality among VAD recipients was associated with age older than 65 years (odds ratio [OR], 1.76; 95% CI, 1.29-2.40), female sex (OR, 1.27; 95% CI, 0.97-1.67), and at least 1 high-risk intervention preceding VAD (OR, 5.52; 95% CI, 4.27-7.13).

conclusionsOlder patients who underwent 1 or more intensive treatments before VAD placement had a nearly 50% inpatient mortality and were unlikely to receive a cardiac transplantation. Refining patient selection might help better align VAD with those most likely to benefit.

Indexed as

AdultAgedAged, 80 and overAge FactorsCross-Sectional StudiesFemaleHeart-Assist DevicesHospital MortalityHumansMaleMiddle AgedProsthesis ImplantationRisk FactorsUnited StatesYoung Adultgeriatricpopulation-level analysisventricular assist device

Identifiers

PMID30579542
PMCPMC8532109

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.