Obesity Is Associated with Driveline Infection of Left Ventricular Assist Devices

  • Mehmet H. Akay
    Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center-Houston and Memorial Hermann-Texas Medical Center, Houston, Texas
  • Sriram S. Nathan
    Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center-Houston and Memorial Hermann-Texas Medical Center, Houston, Texas
  • Rajko Radovancevic
    Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center-Houston and Memorial Hermann-Texas Medical Center, Houston, Texas
  • Gregor Poglajen
    Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center-Houston and Memorial Hermann-Texas Medical Center, Houston, Texas
  • Mateja K. Jezovnik
    Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center-Houston and Memorial Hermann-Texas Medical Center, Houston, Texas
  • Isabella N. Candelaria
    Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center-Houston and Memorial Hermann-Texas Medical Center, Houston, Texas
  • Barbara L. Averill
    Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center-Houston and Memorial Hermann-Texas Medical Center, Houston, Texas
  • Manish K. Patel
    Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center-Houston and Memorial Hermann-Texas Medical Center, Houston, Texas
  • Biswajit Kar
    Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center-Houston and Memorial Hermann-Texas Medical Center, Houston, Texas
  • Igor D. Gregoric
    Department of Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, University of Texas Health Science Center-Houston and Memorial Hermann-Texas Medical Center, Houston, Texas

Description

<jats:p>In patients with left ventricular assist devices (LVADs), the association of driveline infection (DLI) and body mass index (BMI) remains controversial. The aim of this study was to explore a potential correlation between BMI and DLI in the LVAD patient population. A retrospective, single-center study evaluated patients who underwent LVAD implantation between May 2012 and July 2016. Driveline infection was evaluated per Interagency Registry for Mechanically Assisted Circulatory Support established criteria. Of 222 included patients, 80% were male, the average age was 55 years, and the main underlying heart failure diagnosis was nonischemic cardiomyopathy (56%). The majority of patients (65%) received LVAD as destination therapy and 35% as a bridge to transplantation. Average time-to-first DLI was 296 days after LVAD implantation. In comparison to non-DLI group (80%, N = 177), patients in DLI group (20%, N = 45) had a higher BMI (33.5 ± 8.3 kg/m<jats:sup>2</jats:sup> in DLI group <jats:italic toggle="yes">vs</jats:italic>. 28.8 ± 7.5 kg/m<jats:sup>2</jats:sup> in non-DLI group, <jats:italic toggle="yes">p</jats:italic> = 0.0003) and were younger (51 ± 12 years in DLI group <jats:italic toggle="yes">vs.</jats:italic> 56 ± 12 years in non-DLI group, <jats:italic toggle="yes">p</jats:italic> = 0.013). There was a significant correlation between BMI and DLI (<jats:italic toggle="yes">p</jats:italic> < 0.0001), and age was negatively correlated with DLI (<jats:italic toggle="yes">p</jats:italic> = 0.01). Analysis revealed no correlation between time-to-first DLI and BMI. Our data confirm that higher BMI is associated with increased prevalence of DLI in LVAD population, particularly in younger patients. Addressing excessive body weight in this patient cohort may significantly reduce DLI and thereby improve long-term outcomes.</jats:p>

Journal

  • ASAIO Journal

    ASAIO Journal 65 (7), 678-682, 2019-09

    Ovid Technologies (Wolters Kluwer Health)

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