title: A multi-institutional outcome analysis of patients undergoing left ventricular assist device implantation stratified by sex and race.
abstract: Earlier studies have demonstrated disparities in patients undergoing left ventricular assist device (LVAD) implantation when stratified according to sex and race. Because very few data exist from large investigations, we reviewed data from the registry of the Mechanical Circulatory Support Research Network.
  
  
  
  Between May 2004 and September 2014, 734 patients underwent primary LVAD implantation at our institutions. Median age at implant was 57 (range 18 to 82) years and there were 577 males (80%). Race included Caucasian (C) in 586 patients (82%), African-American (AA) in 112 (16%), and other (O) in 21 (3%). Between sexes, significant pre-operative differences most commonly included median age at implant (males 60 years, females 57 years), ischemic etiology (53% vs 35%) and mean INTERMACS profile (2.9 vs 2.5). Between races, significant pre-operative differences most commonly included median age at implant (C = 61 vs AA = 51 vs O = 51), New York Heart Association functional class (85% vs 100% vs 92%) and ischemic etiology (55% vs 24% vs 40%).
  
  
  
  There were no significant differences in survival at 1, 3 or 5 years by sex or race. Similarly, there were no differences in time-related freedom from stroke, drive-line infection, gastrointestinal bleeding or pump thrombus by sex or race. After controlling for differences, neither sex nor race was associated with survival (p = 0.09 and p = 0.18, respectively), stroke (p = 0.28 and p = 0.21), drive-line infection (p = 0.9 and p = 0.92), gastrointestinal bleed (p = 0.48 and p = 0.45) or pump thrombus (p = 0.99 and p = 0.8).
  
  
  
  In this large, multi-institutional analysis, although some pre-operative clinical characteristics varied, they did not translate into any significant differences in late survival or complications while on LVAD support.
authors: Department of Cardiovascular Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors: Justin van
authors: JV
authors: Meeteren
authors: Department of Cardiovascular Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors: Simon
authors: S
authors: Maltais
authors: Department of Cardiovascular Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors: Shannon M
authors: SM
authors: Dunlay
authors: Department of Cardiovascular Surgery, Vanderbilt Heart and Vascular Center, Nashville, Tennessee, USA.
authors: Nicholas A
authors: NA
authors: Haglund
authors: Department of Cardiovascular Surgery, Vanderbilt Heart and Vascular Center, Nashville, Tennessee, USA.
authors: Mary
authors: M
authors: Beth Davis
authors: Division of Cardiovascular Diseases, St. Vincent's Hospital, Indianapolis, Indiana, USA.
authors: Jennifer
authors: J
authors: Cowger
authors: Division of Cardiovascular Diseases, Inova Heart and Vascular Institute, Falls Church, Virginia, USA.
authors: Palak
authors: P
authors: Shah
authors: Department of Cardiac Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA.
authors: Keith D
authors: KD
authors: Aaronson
authors: Department of Cardiac Surgery, University of Michigan Health System, Ann Arbor, Michigan, USA.
authors: Francis D
authors: FD
authors: Pagani
authors: Department of Cardiovascular Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA. Electronic address: stulak.john@mayo.edu.
authors: John M
authors: JM
authors: Stulak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000208:ethnology / Q000601:surgery*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000208:ethnology*; D011475:Prosthesis Failure; D044469:Racial Groups; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D012737:Sex Factors; D015996:Survival Rate / Q000639:trends; D013927:Thrombosis / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: disparities; mechanical circulatory assistance; race; ventricular assist device