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Poor Outcomes Associated with Ventricular Assist Devices

Early mortality, morbidity and costs remain high in Medicare patients, despite receiving a ventricular assist device

TUESDAY, Nov. 25 (HealthDay News) -- Patients receiving a ventricular assist device would benefit from improvements in patient selection and reductions in perioperative mortality risks to reduce early mortality and morbidity, according to a study published in the Nov. 26 issue of the Journal of the American Medical Association.

Adrian F. Hernandez, M.D., of the Duke Clinical Research Institute in Durham, N.C., and colleagues investigated both the acute and long-term outcomes of patients who received a ventricular assist device. All patients were Medicare fee-for-service beneficiaries, and between 2000 and 2006 had received the device either as primary therapy or within 30 days following a cardiotomy.

Approximately half of patients in both the primary therapy (55.6 percent) and cardiotomy (48.3 percent) groups were readmitted to the hospital within six months, the researchers report. However, patients in the primary therapy group spent a longer average time in the hospital (29.8 days versus 16.7 days, respectively). The investigators note that a similar proportion of patients were alive at one year (73.2 percent versus 76.6 percent, respectively). The overall one-year survival rate was 51.6 percent and 30.8 percent in the primary therapy and cardiotomy groups, respectively, and the average one-year Medicare payment for inpatient care was $178,714 and $111,769, respectively.

"Among Medicare beneficiaries receiving a ventricular assist device, early mortality, morbidity and costs remain high. Improving patient selection and reducing perioperative mortality are critical for improving overall outcomes," the authors conclude.

Several of the study authors report financial relationships with the pharmaceutical industry.

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