Risk factors for neurological complications and clinical outcomes in patients with left ventricular assist devices

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dc.contributor.authorKodik, Meltem Songur
dc.contributor.authorYildiz, Ali Kemal
dc.contributor.authorUz, Ilhan
dc.contributor.authorYalcinli, Sercan
dc.contributor.authorKahraman, Umit
dc.contributor.authorBolat, Elif
dc.contributor.authorAltunci, Yusuf Ali
dc.date.accessioned2021-05-03T20:33:29Z
dc.date.available2021-05-03T20:33:29Z
dc.date.issued2021
dc.departmentEge Üniversitesien_US
dc.description.abstractObjectives: Patients with left ventricular assist devices (LVADs) frequently experience cerebrovascular complications. We investigated the complications, including intracranial hemorrhage (ICH) and ischemic stroke (IS), in patients with LVADs. Methods: A historical cohort study was performed at an emergency clinic including patients who underwent LVAD placement between February 16, 2015, and April 1, 2020. of the 295 patients with LVADs, 71 (24.1%) were admitted to the emergency service between the study dates because of IS and ICH. Electronic medical files were reviewed, and patients were categorized as ICH or IS. Results: of the included patients, 245 (83.0%) were male. The most common postoperative complications were pump thrombosis (26.8%, n = 79), blood culture positivity (19.3%, n = 57), and surgical bleeding (5.8%, n = 17). The most frequent LVAD indication was ischemic dilated cardiomyopathy (71.5%, n = 211). The mean age was 49.6 +/- 16.7 and 51.3 +/- 14.8 years for patients with and without neurological complications, respectively (P = 0.415). Neurological complications were seen in 65 (31.3%) patients with and in 6 (6.9%) patients without coronary ischemia (P < 0.001). Neurological complications were found in 39 (30.5%) patients with an implantable cardioverter defibrillator (ICD) and in 32 (19.2%) patients without an ICD (P = 0.024). Neurological complications were found in 19 (61.3%) patients with and in 52 (19.7%) patients without a history of stroke (P < 0.001). Logistic regression analysis revealed that age and Glasgow coma scale (GCS) were the only significant variables independently affecting mortality status. While a younger age was a protective factor, a one-unit increase in the GCS was associated with a 4.1-fold (95% CI: 1.308-13.071) increase in mortality. Conclusions: Coronary ischemia, ICD, cerebrovascular disease, and smoking significantly affected the presence of complications. Moreover, patients with combined IS and ICH had a lower chance of recovering. Interventional procedures should be performed as early as possible, especially in elderly patients with a low GCS.en_US
dc.identifier.doi10.22514/sv.2020.16.0114
dc.identifier.endpage151en_US
dc.identifier.issn1334-5605
dc.identifier.issn1845-206X
dc.identifier.issn1334-5605en_US
dc.identifier.issn1845-206Xen_US
dc.identifier.issue1en_US
dc.identifier.scopus2-s2.0-85101093297en_US
dc.identifier.scopusqualityQ3en_US
dc.identifier.startpage143en_US
dc.identifier.urihttps://doi.org/10.22514/sv.2020.16.0114
dc.identifier.urihttps://hdl.handle.net/11454/70042
dc.identifier.volume17en_US
dc.identifier.wosWOS:000606825400025en_US
dc.identifier.wosqualityQ4en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherMre Pressen_US
dc.relation.ispartofSigna Vitaeen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectLeft ventricular assist devicesen_US
dc.subjectNeurological complicationen_US
dc.subjectStrokeen_US
dc.subjectAge. Glasgow coma scaleen_US
dc.titleRisk factors for neurological complications and clinical outcomes in patients with left ventricular assist devicesen_US
dc.typeArticleen_US

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