Abstract 16383: Contemporary Costs of Care Stratified by INTERMACS Profiles Among Patients Undergoing Primary Left Ventricular Assist Device Implantation
Introduction: Durable mechanical circulatory support (dMCS) is an integral part of advanced heart failure (AHF) management. Risk stratification for patients undergoing dMCS using the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profiles is well-established in predicting clinical outcomes.
Hypothesis: Hospitalization costs and length of stay during primary left ventricular assist device (LVAD) implantation are increased in patients with lower pre-operative INTERMACS profiles.
Methods: This was a retrospective study of patients undergoing primary HeartMate II LVAD implantation at the University of Virginia from January 2009 through May 2016. Potential variables contributing to the hospitalization costs and length of stay were assessed using linear regression analysis.
Results: Of the 162 patients included in this study, 76.8% were male. The mean age was 55.1 (SD=13.1) years and the mean Charlson comorbidity index was 3.4 (SD=2.3). The median hospitalization costs per patient significantly increased with lower INTERMACS profiles and were $168,264 (11.7%), $176,128 (43.8%), $253,635 (40.7%), and $349,065 (3.7%) for INTERMACS profile 4, 3, 2, and 1 patients, respectively (p<0.0001). The mean length of stay for INTERMACS profile 3 and 4 (30.9 days) was significantly lower than that for INTERMACS profile 1 and 2 (48.0 days) patients (p<0.0001). In-hospital mortality was 6.6% for INTERMACS profile 3 and 4 compared to 18.1% for INTERMACS profile 1 and 2 patients (p=0.02). Linear regression analysis demonstrated that a lower INTERMACS profile was independently predictive of increased hospitalization costs (p<0.0001) and length of stay (p<0.0001).
Conclusions: Stratification of AHF patients undergoing primary dMCS by INTERMACS profile can be helpful in anticipating increased hospitalization costs and length of stay. Timely consideration for dMCS in patients with AHF may lead to lower health care costs.
Author Disclosures: B.T. Lawlor: None. K. Bilchick: None. C. Ballew: None. L. Smith: None. K. Scully: None. T. Welch: None. J.D. Bergin: None. J.L. Kennedy: None. M. Abuannadi: None. S. Mazimba: None.
- © 2016 by American Heart Association, Inc.