Abstract 217: Characteristics and 1-year Outcomes of Patients with Long-term Left Ventricular Assist Devices (LVAD) in Quebec Compared with the INTERMACS Registry
Notice bibliographique
Résumé
Introduction: 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 of LVAD and 1-year results in Quebec compared with the INTERMACS registry. Methods: A retrospective review of all pertinent hospital data sources of all LVAD-implanted patients in 20102-12 was performed. Variables, definitions and time points (pre-implant, implant, 1 month, 1 year) were based on the INTERMACS registry and results were compared during the same period. Major clinical outcomes (death, transplant, recovery) and adverse events were determined during 1-year follow up for the entire cohort. Results: During 2010-2012, 53 LVADs were implanted in Quebec (3 centers). Patients were mostly male (77 %) with a median age of 57 years (interquartile range, IQR: 50-60); 34% were ≥60 years old compared to 47% in INTERMACS. The proportion of Quebec patients with an INTERMACS profile 1 (critical cardiogenic shock; 13%) and 2 (progressive decline; 40%) were very similar to INTERMACS. However, the proportion with INTERMACS profile 3 (stable, inotrope-dependent) was higher in Quebec (43%) than in INTERMACS (27%); in the latter, more patients had INTERMACS profiles 4 (symptoms at rest) to 7 (NYHA Class III). Forty-nine percent of Quebec patients were not on the transplant list at the time of implantation compared to 75% in INTERMACS. LVAD as destination therapy was much less frequent in Quebec (11%) than in INTERMACS (36%). After LVAD implantation, median intensive care unit stay was 7 days (IQR: 5-14) and median hospital stay for patients who were discharged on support was 24 days (IQR: 20 - 41). At 1-year, major clinical outcomes of Quebec patients (alive on support 57%; died on support 17%; transplant 24%; explant 2%) were virtually identical to those in INTERMACS. One-year survival for patients on versus not on the transplant list at the time of implantation was not significantly different (p=0.13). As in INTERMACS patients, the most frequent adverse events in Quebec patients were infection, hemorrhage, arrhythmia and right heart failure. Conclusion: In comparison with INTERMACS patients, Quebec LVAD patients are younger but sicker and less likely to be implanted as destination therapy. Despite low volumes, clinical results in Quebec hospitals are very similar to those reported for INTERMACS. Only half of Quebec LVAD patients were on the transplant list at the time of implant. Similar clinical results for patients on and off the transplant list in Quebec support the recommendation that transplant eligibility should not be an essential criterion for selection of patients for LVAD. Continued independent monitoring in collaboration with hospitals will be important to optimize quality of care.
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 ».