Abstract 374: Characteristics and Clinical Outcomes of Patients with Long-term Left Ventricular Assist Devices in Quebec Compared with the INTERMACS Registry
Notice bibliographique
Résumé
Background: After a review of the evidence, our publicly funded cardiology evaluation unit recommended to the Quebec Ministry of Health that use of long-term left ventricular assist devices (LVAD) should be carefully monitored and not limited to bridge-to-transplant patients. Herein, we describe use and clinical outcomes of LVAD in Quebec during the latest 5-year period in comparison with results reported by the INTERMACS registry. Methods: A retrospective review of all pertinent hospital data sources of all LVAD-implanted patients in 2010-14 was performed with follow-up of major clinical outcomes to January 2015. Results: In Quebec’s 3 LVAD centers, 83 LVADs were implanted during 2010-14. Annual center patient volume varied from 0 to 24. Patients were mostly male (80%). Median age was 56 years (interquartile range, IQR: 45-62). The proportion of patients ≥ 60 years was 35% versus 49.5% in INTERMACS. For INTERMACS profiles that include inotrope dependence, the proportions of Quebec patients were very similar to INTERMACS for profile 1 (critical cardiogenic shock; 13% vs 15%, respectively) and profile 2 (progressive decline; 36% vs 36%) but higher for profile 3 (stable but inotrope dependent; 40% vs 30%). The proportion of patients who were not on the transplant list at the time of implantation was lower in Quebec (53%; 44/83) than in INTERMACS (78%) and destination therapy was much less frequent (11% [9/83] vs 43%). For patients implanted during 2010-13 (n=65), 1-year major clinical outcomes in Québec were very similar to INTERMACS (2006-2013): deaths, 17% vs 18%; cardiac transplantation, 22% vs 20%; LVAD removal because of myocardial recovery, 3% vs 1%; alive with LVAD support, 58% vs 61%. Clinical results at 1 year were similar for Quebec patients on and not on the transplant list at the time of implant (p=0.11). Two-thirds of the cohort had 2-year follow-up: 21% (12/56) died; 43% (24/56) had transplantation; 5% recovered and had LVAD removal; and 30% (17/56) were alive with LVAD. For patients implanted during 2014 (n=18), the median duration of follow-up was about 5 months and 5.6% had died on LVAD support. Among all Quebec patients (2010-2014), most recent follow-up indicates that 26% (9/32) of patients transplanted after LVAD support have died. Conclusions: In comparison with INTERMACS, Quebec LVAD patients were younger, more likely to be inotrope-dependent and less likely to be implanted as destination therapy. Despite relatively low center volumes, clinical outcomes for Quebec were very similar to INTERMACS. Results according to transplant list status at time of implant support the recommendation that transplant eligibility should not be an essential criterion for selection of patients for LVAD. Continued independent monitoring of LVAD patients, even after explant or transplant, will be important to optimize the value and quality of care of end-stage heart failure patients.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».