Clinical and economic impact of ventricular assist device infections: a real-world claims analysis.

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Citation: Journal of Medical Economics. 27(1):62-68, 2024 Jan-Dec.PMID: 38084737Department: MedStar Heart and Vascular Institute, BaltimoreForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Heart Failure | *Heart-Assist Devices | Heart Failure/th [Therapy] | Heart-Assist Devices/ae [Adverse Effects] | Humans | Insurance Claim Review | Retrospective Studies | Risk Factors | Treatment Outcome | United States/ep [Epidemiology]Year: 2024ISSN:
  • 1369-6998
Name of journal: Journal of medical economicsAbstract: BACKGROUND: VAD therapy has revolutionized the treatment of end-stage heart failure, but infections remain an important complication. The objective of this study was to characterize the clinical and economic impacts of VAD-specific infections.CONCLUSIONS: VAD infections were associated with higher mortality, more healthcare utilization, and higher total cost. Strategies to minimize VAD-specific infections could lead to improved clinical and economic outcomes.METHODS: A retrospective analysis of a United States claims database identified members >= 18 years with a claim for a VAD implant procedure, at least 6 months of pre-implant baseline data, and 12 months of follow-up between 1 June 2016 and 31 December 2019. Cumulative incidence of infection was calculated. Infection and non-infection cohorts were compared regarding mortality, healthcare utilization, and total cost. Regression models were used to identify risk factors associated with infections and mortality.RESULTS: A total of 2,259 patients with a VAD implant were included, with 369 experiencing infection (12-month cumulative incidence 16.1%). Patients with infection were 2.1 times more likely to die (p < 0.001, 95% CI [1.5-2.9]). The mean 12-month total cost per US patient was All authors: Peleg AY, Feller ED, Muller M, Schulte-Eistrup S, McGiffin D, Zimpfer D, Holbrook R, Margetta J, Seshadri S, Mokadam NAFiscal year: FY2024Digital Object Identifier: Date added to catalog: 2024-01-16
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Journal Article MedStar Authors Catalog Article 38084737 Available 38084737

BACKGROUND: VAD therapy has revolutionized the treatment of end-stage heart failure, but infections remain an important complication. The objective of this study was to characterize the clinical and economic impacts of VAD-specific infections.

CONCLUSIONS: VAD infections were associated with higher mortality, more healthcare utilization, and higher total cost. Strategies to minimize VAD-specific infections could lead to improved clinical and economic outcomes.

METHODS: A retrospective analysis of a United States claims database identified members >= 18 years with a claim for a VAD implant procedure, at least 6 months of pre-implant baseline data, and 12 months of follow-up between 1 June 2016 and 31 December 2019. Cumulative incidence of infection was calculated. Infection and non-infection cohorts were compared regarding mortality, healthcare utilization, and total cost. Regression models were used to identify risk factors associated with infections and mortality.

RESULTS: A total of 2,259 patients with a VAD implant were included, with 369 experiencing infection (12-month cumulative incidence 16.1%). Patients with infection were 2.1 times more likely to die (p < 0.001, 95% CI [1.5-2.9]). The mean 12-month total cost per US patient was 54,339 for the non-infection cohort and 97,546 for the infection cohort, a difference of 3,207 (p < 0.0001).

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