Subclinical Cardiac Injury And Clinical Congestion
HFSA ePoster Library. Kelly S. 09/10/21; 343443; 211
Samuel Kelly
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Abstract
Discussion Forum (0)
Introduction: Heart failure (HF) is a prevalent medical condition noted in 6.2 million adults in the United States. Morbidity and mortality have been reduced by initiation of advanced HF therapies, including left ventricular assist device (LVAD) use or heart transplants (HT). However, it has been shown that certain vulnerable populations have worse HF outcomes, such as women, racial and ethnic minorities, and those of lower socioeconomic status (SES). Another potentially at-risk group is those with a lower level of education. To the best of our knowledge, there have not been any studies that assess level of education and outcomes in patients with LVADs.
Hypothesis: We hypothesize that a lower level of education will have worse HF outcomes, particularly when assessing patients with Medicare or Medicaid insurance.
Methods: We performed a single-center retrospective analysis of patients who received LVADs between June 2006 and December 2016 at the Ohio State University Wexner Medical Center (n=109). These patients had either Medicare or Medicaid for insurance. Patients were stratified into three groups based on level of education: did not complete high school, completed only high school, or completed a college degree. Primary outcomes of interest were time to readmission and mortality, evaluated by time to event analysis.
Results: Of those with Medicare, patients that did not complete high school had the lowest 1-year post LVAD implantation survival (log-rank p=0.0071). Regarding our survival analysis, having a college degree was a significant independent predictor for survival with an 80% reduction in mortality (HR 0.20 [0.06-0.63], p-value 0.006). Severe right ventricular failure also had a 2.8-fold increase in mortality (HR 2.81 [1.15-6.89], p-value 0.023). Patients with Medicaid for insurance did not have level of education associated with any primary outcomes.
Conclusions: Medicare LVAD recipients with a lower level of education were at a higher risk of mortality. This may be related to age, lack of access to technology, or inability to comprehend new technology. Further research is needed in this field, in addition to tailoring pre and post LVAD education programs for this population.
Hypothesis: We hypothesize that a lower level of education will have worse HF outcomes, particularly when assessing patients with Medicare or Medicaid insurance.
Methods: We performed a single-center retrospective analysis of patients who received LVADs between June 2006 and December 2016 at the Ohio State University Wexner Medical Center (n=109). These patients had either Medicare or Medicaid for insurance. Patients were stratified into three groups based on level of education: did not complete high school, completed only high school, or completed a college degree. Primary outcomes of interest were time to readmission and mortality, evaluated by time to event analysis.
Results: Of those with Medicare, patients that did not complete high school had the lowest 1-year post LVAD implantation survival (log-rank p=0.0071). Regarding our survival analysis, having a college degree was a significant independent predictor for survival with an 80% reduction in mortality (HR 0.20 [0.06-0.63], p-value 0.006). Severe right ventricular failure also had a 2.8-fold increase in mortality (HR 2.81 [1.15-6.89], p-value 0.023). Patients with Medicaid for insurance did not have level of education associated with any primary outcomes.
Conclusions: Medicare LVAD recipients with a lower level of education were at a higher risk of mortality. This may be related to age, lack of access to technology, or inability to comprehend new technology. Further research is needed in this field, in addition to tailoring pre and post LVAD education programs for this population.
Introduction: Heart failure (HF) is a prevalent medical condition noted in 6.2 million adults in the United States. Morbidity and mortality have been reduced by initiation of advanced HF therapies, including left ventricular assist device (LVAD) use or heart transplants (HT). However, it has been shown that certain vulnerable populations have worse HF outcomes, such as women, racial and ethnic minorities, and those of lower socioeconomic status (SES). Another potentially at-risk group is those with a lower level of education. To the best of our knowledge, there have not been any studies that assess level of education and outcomes in patients with LVADs.
Hypothesis: We hypothesize that a lower level of education will have worse HF outcomes, particularly when assessing patients with Medicare or Medicaid insurance.
Methods: We performed a single-center retrospective analysis of patients who received LVADs between June 2006 and December 2016 at the Ohio State University Wexner Medical Center (n=109). These patients had either Medicare or Medicaid for insurance. Patients were stratified into three groups based on level of education: did not complete high school, completed only high school, or completed a college degree. Primary outcomes of interest were time to readmission and mortality, evaluated by time to event analysis.
Results: Of those with Medicare, patients that did not complete high school had the lowest 1-year post LVAD implantation survival (log-rank p=0.0071). Regarding our survival analysis, having a college degree was a significant independent predictor for survival with an 80% reduction in mortality (HR 0.20 [0.06-0.63], p-value 0.006). Severe right ventricular failure also had a 2.8-fold increase in mortality (HR 2.81 [1.15-6.89], p-value 0.023). Patients with Medicaid for insurance did not have level of education associated with any primary outcomes.
Conclusions: Medicare LVAD recipients with a lower level of education were at a higher risk of mortality. This may be related to age, lack of access to technology, or inability to comprehend new technology. Further research is needed in this field, in addition to tailoring pre and post LVAD education programs for this population.
Hypothesis: We hypothesize that a lower level of education will have worse HF outcomes, particularly when assessing patients with Medicare or Medicaid insurance.
Methods: We performed a single-center retrospective analysis of patients who received LVADs between June 2006 and December 2016 at the Ohio State University Wexner Medical Center (n=109). These patients had either Medicare or Medicaid for insurance. Patients were stratified into three groups based on level of education: did not complete high school, completed only high school, or completed a college degree. Primary outcomes of interest were time to readmission and mortality, evaluated by time to event analysis.
Results: Of those with Medicare, patients that did not complete high school had the lowest 1-year post LVAD implantation survival (log-rank p=0.0071). Regarding our survival analysis, having a college degree was a significant independent predictor for survival with an 80% reduction in mortality (HR 0.20 [0.06-0.63], p-value 0.006). Severe right ventricular failure also had a 2.8-fold increase in mortality (HR 2.81 [1.15-6.89], p-value 0.023). Patients with Medicaid for insurance did not have level of education associated with any primary outcomes.
Conclusions: Medicare LVAD recipients with a lower level of education were at a higher risk of mortality. This may be related to age, lack of access to technology, or inability to comprehend new technology. Further research is needed in this field, in addition to tailoring pre and post LVAD education programs for this population.
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