Cargando…

The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices

We aimed to identify a simple metric accounting for peri-procedural hemoglobin changes, independent of blood product transfusion strategies, and assess its correlation with outcomes in patients undergoing left ventricular assist device (LVAD) implantation We included consecutive patients undergoing...

Descripción completa

Detalles Bibliográficos
Autores principales: Shore, Supriya, Hanff, Thomas C., Mazurek, Jeremy A., Fox, Arieh, Tanna, Monique S., Grandin, Edward W., Zhang, Robert, Wald, Joyce, Peters, Carli, Acker, Michael A., Atluri, Pavan, Rame, J. Eduardo, Goldberg, Lee R., Jessup, Mariell, Margulies, Kenneth B., Birati, Edo Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369576/
https://www.ncbi.nlm.nih.gov/pubmed/35956132
http://dx.doi.org/10.3390/jcm11154517
_version_ 1784766504782266368
author Shore, Supriya
Hanff, Thomas C.
Mazurek, Jeremy A.
Fox, Arieh
Tanna, Monique S.
Grandin, Edward W.
Zhang, Robert
Wald, Joyce
Peters, Carli
Acker, Michael A.
Atluri, Pavan
Rame, J. Eduardo
Goldberg, Lee R.
Jessup, Mariell
Margulies, Kenneth B.
Birati, Edo Y.
author_facet Shore, Supriya
Hanff, Thomas C.
Mazurek, Jeremy A.
Fox, Arieh
Tanna, Monique S.
Grandin, Edward W.
Zhang, Robert
Wald, Joyce
Peters, Carli
Acker, Michael A.
Atluri, Pavan
Rame, J. Eduardo
Goldberg, Lee R.
Jessup, Mariell
Margulies, Kenneth B.
Birati, Edo Y.
author_sort Shore, Supriya
collection PubMed
description We aimed to identify a simple metric accounting for peri-procedural hemoglobin changes, independent of blood product transfusion strategies, and assess its correlation with outcomes in patients undergoing left ventricular assist device (LVAD) implantation We included consecutive patients undergoing LVAD implantation at a single center between 10/1/2008 and 6/1/2014. The anemia stress index (ASI), defined as the sum of number of packed red blood cells transfused and the hemoglobin changes after LVAD implantation, was calculated for each patient at 24 h, discharge, and 3 months after LVAD implantation. Our cohort included 166 patients (80.1% males, mean age 56.3 ± 15.6 years) followed up for a median of 12.3 months. Increases in ASI per unit were associated with a higher hazard for all-cause mortality and early RV failure. The associations between the ASI and all-cause mortality persisted after multivariable adjustment, irrespective of when it was calculated (adjusted HR of 1.11, 95% CI 1.03–1.20 per unit increase in ASI). Similarly, ASI at 24 h after implant was associated with early RV failure despite multivariable adjustment (OR 1.09, 95% CI 1.05–1.14). We present a novel metric, the ASI, that is correlated with an increased risk for all-cause mortality and early RV failure in LVAD recipients.
format Online
Article
Text
id pubmed-9369576
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-93695762022-08-12 The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices Shore, Supriya Hanff, Thomas C. Mazurek, Jeremy A. Fox, Arieh Tanna, Monique S. Grandin, Edward W. Zhang, Robert Wald, Joyce Peters, Carli Acker, Michael A. Atluri, Pavan Rame, J. Eduardo Goldberg, Lee R. Jessup, Mariell Margulies, Kenneth B. Birati, Edo Y. J Clin Med Article We aimed to identify a simple metric accounting for peri-procedural hemoglobin changes, independent of blood product transfusion strategies, and assess its correlation with outcomes in patients undergoing left ventricular assist device (LVAD) implantation We included consecutive patients undergoing LVAD implantation at a single center between 10/1/2008 and 6/1/2014. The anemia stress index (ASI), defined as the sum of number of packed red blood cells transfused and the hemoglobin changes after LVAD implantation, was calculated for each patient at 24 h, discharge, and 3 months after LVAD implantation. Our cohort included 166 patients (80.1% males, mean age 56.3 ± 15.6 years) followed up for a median of 12.3 months. Increases in ASI per unit were associated with a higher hazard for all-cause mortality and early RV failure. The associations between the ASI and all-cause mortality persisted after multivariable adjustment, irrespective of when it was calculated (adjusted HR of 1.11, 95% CI 1.03–1.20 per unit increase in ASI). Similarly, ASI at 24 h after implant was associated with early RV failure despite multivariable adjustment (OR 1.09, 95% CI 1.05–1.14). We present a novel metric, the ASI, that is correlated with an increased risk for all-cause mortality and early RV failure in LVAD recipients. MDPI 2022-08-03 /pmc/articles/PMC9369576/ /pubmed/35956132 http://dx.doi.org/10.3390/jcm11154517 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shore, Supriya
Hanff, Thomas C.
Mazurek, Jeremy A.
Fox, Arieh
Tanna, Monique S.
Grandin, Edward W.
Zhang, Robert
Wald, Joyce
Peters, Carli
Acker, Michael A.
Atluri, Pavan
Rame, J. Eduardo
Goldberg, Lee R.
Jessup, Mariell
Margulies, Kenneth B.
Birati, Edo Y.
The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices
title The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices
title_full The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices
title_fullStr The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices
title_full_unstemmed The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices
title_short The Anemia Stress Index—Anemia, Transfusions, and Mortality in Patients with Continuous Flow Ventricular Assist Devices
title_sort anemia stress index—anemia, transfusions, and mortality in patients with continuous flow ventricular assist devices
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9369576/
https://www.ncbi.nlm.nih.gov/pubmed/35956132
http://dx.doi.org/10.3390/jcm11154517
work_keys_str_mv AT shoresupriya theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT hanffthomasc theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT mazurekjeremya theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT foxarieh theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT tannamoniques theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT grandinedwardw theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT zhangrobert theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT waldjoyce theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT peterscarli theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT ackermichaela theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT atluripavan theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT ramejeduardo theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT goldbergleer theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT jessupmariell theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT margulieskennethb theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT biratiedoy theanemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT shoresupriya anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT hanffthomasc anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT mazurekjeremya anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT foxarieh anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT tannamoniques anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT grandinedwardw anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT zhangrobert anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT waldjoyce anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT peterscarli anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT ackermichaela anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT atluripavan anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT ramejeduardo anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT goldbergleer anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT jessupmariell anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT margulieskennethb anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices
AT biratiedoy anemiastressindexanemiatransfusionsandmortalityinpatientswithcontinuousflowventricularassistdevices