{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T14:13:58Z","timestamp":1782828838473,"version":"3.54.5"},"reference-count":37,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T00:00:00Z","timestamp":1708560000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>The 2018 heart allocation system has significantly influenced heart transplantation and left ventricular assist device (LVAD) utilization. Our study aims to investigate age-related outcomes following LVAD implantation in the post-allocation era. Using the National Inpatient Sample, we analyzed data from 7375 patients who underwent LVAD implantation between 2019 and 2020. The primary endpoint was in-hospital mortality following LVAD implantation, stratified by age categories. The age groups were 18\u201349, 50\u201359, 60\u201369, and over 70. These represented 26%, 26%, 31%, and 17% of patients, respectively. Patients aged 60\u201369 and those over 70 exhibited higher in-hospital mortality rates of 12% and 17%, respectively, compared to younger age groups (7% for 18\u201349 and 6% for 50\u201359). The age groups 60\u201369 and over 70 were independent predictors of mortality, with adjusted odds ratios of 1.99 (p = 0.02; 95% confidence interval [CI], 1.12\u20133.57) and 2.88 (p = 0.002; 95% CI, 1.45\u20135.71), respectively. Additionally, a higher Charlson Comorbidity Index was associated with increased in-hospital mortality risk (adjusted odds ratio 1.39; p = 0.02; 95% CI, 1.05\u20131.84). Additionally, patients above 70 experienced a statistically shorter length of stay. Nonhome discharge was found to be significantly high across all age categories. However, the difference in hospitalization cost was not statistically significant across the age groups. Our study highlights that patients aged 60 and above face an increased risk of in-hospital mortality following LVAD implantation in the post-allocation era. This study sheds light on age-related outcomes and emphasizes the importance of considering age in LVAD patient selection and management strategies.<\/jats:p>","DOI":"10.3390\/jpm14030236","type":"journal-article","created":{"date-parts":[[2024,2,22]],"date-time":"2024-02-22T11:28:47Z","timestamp":1708601327000},"page":"236","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Age Is a Predictor of In-Hospital Outcomes for Left Ventricular Assist Device Implantation: A Nationwide Analysis"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3247-7618","authenticated-orcid":false,"given":"Abdul Rahman","family":"Akkawi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Kansas University School of Medicine-Wichita, Wichita, KS 67214, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4553-608X","authenticated-orcid":false,"given":"Akira","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Surgery, University of Tsukuba, Tsukuba 305-8577, Ibaraki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Shimamura","sequence":"additional","affiliation":[{"name":"Division of Cardiothoracic Surgery, Department of Surgery, Westchester Medical Center, Valhalla, NY 10595, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Chehab","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Johns Hopkins University Baltimore, Baltimore, MD 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulino","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH 44195, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiki","family":"Kuno","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5740-9670","authenticated-orcid":false,"given":"Alexandros","family":"Briasoulis","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Section of Heart Failure and Transplantation, University of Iowa, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1111\/ajt.15676","article-title":"OPTN\/SRTR 2018 Annual Data Report: Heart","volume":"20","author":"Colvin","year":"2020","journal-title":"Am. J. Transpl."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.1016\/j.jacc.2015.07.075","article-title":"Risk Assessment and Comparative Effectiveness of Left Ventricular Assist Device and Medical Management in Ambulatory Heart Failure Patients: Results from the ROADMAP Study","volume":"66","author":"Estep","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1097\/MAT.0000000000001599","article-title":"Durable Left Ventricular Assist Device as a Bridge to Heart Transplantation under the New Donor Heart Allocation System","volume":"68","author":"Nordan","year":"2021","journal-title":"ASAIO J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2781","DOI":"10.1111\/ajt.16010","article-title":"A change of heart: Preliminary results of the US 2018 adult heart allocation revision","volume":"20","author":"Goff","year":"2020","journal-title":"Am. J. Transpl."},{"key":"ref_5","unstructured":"Organ Procurement and Transplantation Network (2023, May 22). Adult Heart Allocation, Available online: https:\/\/optn.transplant.hrsa.gov\/professionals\/by-organ\/heart-lung\/adult-heart-allocation\/."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.healun.2022.08.022","article-title":"Bridging to transplant with HeartMate 3 left ventricular assist devices in the new heart organ allocation system: An individualized approach","volume":"42","author":"Uriel","year":"2023","journal-title":"J. Heart Lung Transpl."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1007\/s11845-020-02246-y","article-title":"Predictors of in-hospital mortality in patients with left ventricular assist device","volume":"189","author":"Gonuguntla","year":"2020","journal-title":"Ir. J. Med. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Khalil, F., Asleh, R., Perue, R.K., Weinstein, J.-M., Solomon, A., Betesh-Abay, B., Briasoulis, A., and Alnsasra, H. (2023). Vascular Function in Continuous Flow LVADs: Implications for Clinical Practice. Biomedicines, 11.","DOI":"10.3390\/biomedicines11030757"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2460","DOI":"10.1111\/aor.14363","article-title":"Characteristics and outcomes of left ventricular assist device recipients transplanted before and after the new donor heart allocation system","volume":"46","author":"Doulamis","year":"2022","journal-title":"Artif. Organs"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1111\/j.1540-8191.2011.01292.x","article-title":"Temporal changes in hospital costs for left ventricular assist device implantation","volume":"26","author":"Slaughter","year":"2011","journal-title":"J. Card. Surg."},{"key":"ref_11","unstructured":"(2023, April 22). Healthcare Cost and Utilization Project (HCUP): HCUP Nationwide Inpatient Sample, Available online: http:\/\/www.hcup-us.ahrq.gov\/nisoverview.jsp."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1093\/aje\/kwq433","article-title":"Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries","volume":"173","author":"Quan","year":"2011","journal-title":"Am. J. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2011","DOI":"10.1001\/jama.2017.17653","article-title":"Adherence to Methodological Standards in Research Using the National Inpatient Sample","volume":"318","author":"Khera","year":"2017","journal-title":"JAMA"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"186","DOI":"10.21037\/acs-2021-cfmcs-35","article-title":"Contemporary outcomes of continuous-flow left ventricular assist devices-a systematic review","volume":"10","author":"McNamara","year":"2021","journal-title":"Ann. Cardiothorac. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1016\/j.jacc.2022.01.017","article-title":"Trends and Outcomes of Left Ventricular Assist Device Therapy: JACC Focus Seminar","volume":"79","author":"Varshney","year":"2022","journal-title":"J. Am. Coll Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1053\/j.semtcvs.2016.05.013","article-title":"A Decade of Experience with Continuous-Flow Left Ventricular Assist Devices","volume":"28","author":"John","year":"2016","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Karimov, J.H., Fukamachi, K., and Starling, R.C. (2020). Mechanical Support for Heart Failure: Current Solutions and New Technologies, Springer International Publishing.","DOI":"10.1007\/978-3-030-47809-4"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1097\/MAT.0000000000001123","article-title":"Transition from Conventional Technique to Less Invasive Approach in Left Ventricular Assist Device Implantations","volume":"66","author":"Gunay","year":"2020","journal-title":"ASAIO J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.jtcvs.2022.09.037","article-title":"Effect of the 2018 heart allocation system on patients with durable left ventricular assist devices","volume":"167","author":"Li","year":"2024","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.jchf.2021.01.010","article-title":"Changes in Use of Left Ventricular Assist Devices as Bridge to Transplantation with New Heart Allocation Policy","volume":"9","author":"Mullan","year":"2021","journal-title":"JACC Heart Fail"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.healun.2019.11.002","article-title":"An early investigation of outcomes with the new 2018 donor heart allocation system in the United States","volume":"39","author":"Cogswell","year":"2020","journal-title":"J. Heart Lung Transpl."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1002\/ehf2.14247","article-title":"How does age affect outcomes after left ventricular assist device implantation: Results from the PCHF-VAD registry","volume":"10","author":"Radhoe","year":"2023","journal-title":"ESC Heart Fail"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.athoracsur.2022.11.023","article-title":"The Society of Thoracic Surgeons Intermacs 2022 Annual Report: Focus on the 2018 Heart Transplant Allocation System","volume":"115","author":"Yuzefpolskaya","year":"2023","journal-title":"Ann. Thorac. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.healun.2016.01.002","article-title":"First Annual IMACS Report: A global International Society for Heart and Lung Transplantation Registry for Mechanical Circulatory Support","volume":"35","author":"Kirklin","year":"2016","journal-title":"J. Heart Lung Transpl."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Melendo-Viu, M., Dobarro, D., Roubin, S.R., Pernas, C.L., Cord\u00f3n, C.M., Lamas, M.V., Esteban, M.P., Mart\u00ednez, M.V., Abu Assi, E., and Romero, R.P. (2023). Left Ventricular Assist Device as a Destination Therapy: Current Situation and the Importance of Patient Selection. Life, 13.","DOI":"10.3390\/life13041065"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1016\/j.jchf.2022.08.002","article-title":"Prediction of survival after implantation of a fully magnetically levitated left ventricular assist device","volume":"10","author":"Mehra","year":"2022","journal-title":"JACC Heart Fail"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/j.jacc.2023.05.066","article-title":"Predictors of 5-Year Mortality in Patients Managed with a Magnetically Levitated Left Ventricular Assist Device","volume":"82","author":"Nayak","year":"2023","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/icvts\/ivaa055","article-title":"Association of previous cardiac surgery with outcomes in left ventricular assist device patients","volume":"31","author":"Ayers","year":"2020","journal-title":"Interact. Cardiovasc. Thorac. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e207241","DOI":"10.14503\/THIJ-20-7241","article-title":"Continuous-Flow Left Ventricular Assist Device Support in Patients with Ischemic Versus Nonischemic Cardiomyopathy","volume":"48","author":"Chou","year":"2021","journal-title":"Tex. Heart Inst. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.hrtlng.2019.05.013","article-title":"Impact of chronic kidney disease on in-hospital outcomes following left ventricular assist device placement: A national perspective","volume":"49","author":"Doshi","year":"2020","journal-title":"Heart Lung"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1016\/j.jtcvs.2019.03.098","article-title":"Left ventricular assist device implantation may be feasible in appropriately selected patients with severe renal insufficiency","volume":"159","author":"Pasrija","year":"2020","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1093\/ejcts\/ezab575","article-title":"The impact of diabetes on short-, intermediate- and long-term mortality following left ventricular assist device implantation","volume":"61","author":"Kogan","year":"2022","journal-title":"Eur. J. Cardio-Thoracic Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1614","DOI":"10.1016\/j.athoracsur.2019.09.021","article-title":"Diabetes Mellitus Is Not a Risk Factor for Patients Supported with Left Ventricular Assist Device","volume":"109","author":"Zhou","year":"2020","journal-title":"Ann. Thorac. Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.thromres.2021.04.010","article-title":"Assessing in-hospital cardiovascular, thrombotic and bleeding outcomes in patients with chronic liver disease undergoing left ventricular assist device implantation","volume":"202","author":"Grant","year":"2021","journal-title":"Thromb. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.healun.2014.02.022","article-title":"Predictors of hospital length of stay after implantation of a left ventricular assist device: An analysis of the INTERMACS registry","volume":"33","author":"Cotts","year":"2014","journal-title":"J. Heart Lung Transpl."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1016\/j.jtcvs.2019.12.121","article-title":"Trends in utilization, mortality, and resource use after implantation of left ventricular assist devices in the United States","volume":"161","author":"Sanaiha","year":"2021","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1016\/j.jacc.2009.06.035","article-title":"Ventricular assist devices the challenges of outpatient management","volume":"54","author":"Wilson","year":"2009","journal-title":"J. Am. Coll. Cardiol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/3\/236\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:03:17Z","timestamp":1760104997000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/3\/236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,22]]},"references-count":37,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["jpm14030236"],"URL":"https:\/\/doi.org\/10.3390\/jpm14030236","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,22]]}}}