Details

Autor(en) / Beteiligte

• Yavar, Zubin
• Cowger, Jennifer A
• Moainie, Sina L
• Salerno, Christopher T
• Ravichandran, Ashwin K

Titel

Bleeding Complication Rates Are Higher in Females after Continuous-Flow Left Ventricular Assist Device Implantation

Ist Teil von

• ASAIO journal (1992), 2018-11, Vol.64 (6), p.748-753

Ort / Verlag

United States: Copyright by the American Society for Artificial Internal Organs

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• The aims of this analysis were to characterize the burden and timing of bleeding events in females versus males on left ventricular assist device (LVAD) support. A single-center retrospective review of 375 patients receiving continuous-flow LVADs was performed. Bleeding events included gastrointestinal, naso-oropharyngeal, gynecologic (GYN), intracranial hemorrhage (ICH), and mediastinal bleeding. Cox hazard ratios (HRs) [95% CI] and incident event rates for females versus males were calculated. Eighty-four females (22%) and 291 males (78%) received an LVAD. There were 189 patients with 406 bleeding events over a median 399 days of support. Two-year freedom from bleeding was 33 ± 6.2% in females and 46 ± 3.7% in males (p = 0.027). Correlates of bleeding included female sex (adjusted HR = 1.6 [1.1–2.2]) and older age (adjusted HR = 1.2 [1.1–1.3] per 10 years). There was no sex-associated difference in 30 day mediastinal bleeding (males 12%; females 16% at 30 days; overall p = 0.35), but incident event rates for overall bleeding and naso-oropharyngeal bleeding were higher in females (p < 0.05) and trends were noted in ICH (eppy0.06 male vs. 0.10 female, p = 0.14). Eight females (10%) experienced 12 GYN bleeding events; five required surgical intervention. In summary, females had a 60% higher hazard of bleeding than males with significant morbidity encountered from mucosa (including vaginal) bleeding. Future large device studies should be inclusive of sex-specific outcomes.