{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T18:34:56Z","timestamp":1763318096352,"version":"3.41.2"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,2,16]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">With a growing population of patients supported by ventricular assist devices (VADs) and the improvement in survival of this patient population, understanding the healthcare system burden is critical to improving outcomes. Thus, we sought to examine national estimates of VAD\u2010related emergency department (ED) visits and characterize their demographic, clinical, and outcomes profile. Additionally, we tested the hypotheses that resource use increased and mortality improved over time.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This retrospective database analysis uses encounter\u2010level data from the 2010 to 2017 Nationwide Emergency Department Sample. The primary outcome was mortality. From 2010 to 2017, &gt;880\u00a0million ED visits were evaluated, with 44\u00a0042 VAD\u2010related ED visits identified. The annual mean visits were 5505 (SD 4258), but increased 16\u2010fold from 2010 to 2017 (824 versus 13\u00a0155). VAD\u2010related ED visits frequently resulted in admission (72%) and\/or death (3.0%). Median inflation\u2010adjusted charges were $25\u00a0679 (interquartile range, $7450, $63\u00a0119) per encounter. The most common primary diagnoses were cardiac (22%), and almost 30% of encounters were because of bleeding, stroke, or device complications. From 2010 to 2017, admission and mortality decreased from 82% to 71% and 3.4% to 2.4%, respectively (\n              <jats:italic>P<\/jats:italic>\n              for trends &lt;0.001, both).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">We present the first study using national\u2010level data to characterize the growing ED resource use and financial burden of patients supported by VAD. During the past decade, admission and mortality rates decreased but remain substantial; in 2017 \u22481 in every 40 VAD ED encounters resulted in death, making it critical that clinical decision\u2013making be optimized for patients with VAD to maximize good outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.018035","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T11:16:48Z","timestamp":1612523808000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["An Increasing Burden of Disease: Emergency Department Visits Among Patients With Ventricular Assist Devices From 2010 to 2017"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3220-7922","authenticated-orcid":false,"given":"Jonathan B.","family":"Edelson","sequence":"first","affiliation":[{"name":"Division of Cardiology Cardiac Center the Children's Hospital of PhiladelphiaUniversity of Pennsylvania Perelman School of Medicine Philadelphia PA"},{"name":"Cardiovascular Outcomes, Quality, and Evaluative Research Center University of Pennsylvania Philadelphia PA"},{"name":"Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8153-7066","authenticated-orcid":false,"given":"Jonathan J.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cardiac Center the Children's Hospital of PhiladelphiaUniversity of Pennsylvania Perelman School of Medicine Philadelphia PA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Katcoff","sequence":"additional","affiliation":[{"name":"Department of Biomedical Health Informatics, Healthcare Analytics Unit the Children's Hospital of Philadelphia Philadelphia 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