Complications of LVAD utilization in older adults.

Overview

BACKGROUND: Yearly rate and mean patient age of left ventricular assist device (LVAD) implantation increased from 2009 to 2014. Data are lacking regarding trends of LVAD implantation in older adults. OBJECTIVES: To describe the trends of LVAD implantation in older adults and the clinical impact of associated procedural complications. METHODS: We retrospectively analyzed the National Inpatient Sample from 2005 to 2014, calculated the percentage of older adults (>65 years of age) among those who underwent LVAD implantation, and compared their clinical characteristics. Primary outcomes were in-hospital mortality and discharge home. RESULTS: In total, 4491 patients were included. The percentage of older adults among those receiving LVAD increased from 12.53% to 31.65% (p<0.01). Older adults were more likely to develop postoperative delirium (17.90% vs. 11.92% in younger patients; p<0.01), which portended lesser odds of discharge home. CONCLUSIONS: Delirium develops with greater incidence in older adults undergoing LVAD implantation, which decreases odds of favorable discharge disposition.