Is There an Association Between Living in a Rural Area and the Incidence of Postoperative Complications or Hospital Readmissions Following Left Ventricular Assist Device (LVAD) Implantation, Compared to Urban Lvad Recipients? A Systematic Review

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Clinical Cardiology Pub Date : 2025-01-01 DOI:10.1002/clc.70068

Samrat Gollapudi, Abhiram Gollapudi, Sri Banala, Sheraj Singh, Kiran Tadi

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Abstract

Background

Left ventricular assist devices (LVADs) are utilized as a therapeutic option for patients with end-stage heart failure. While LVAD implantation can enhance survival rates and quality of life, the procedure has its risks, and postoperative complications are common. This review aims to investigate whether there is an association between living in a rural area and the incidence of postoperative complications or hospital readmissions following LVAD implantation, compared to urban LVAD recipients.

Methods

A comprehensive literature review examined studies that compared postoperative outcomes between rural and urban LVAD recipients. Data on adverse events, hospitalizations, and mortality rates were extracted, focusing on the impact of geographic location on these outcomes.

Results

The review found that rural LVAD recipients may be at a higher risk for certain complications, including gastrointestinal bleeding, ventricular arrhythmias, LVAD complications, and stroke. Rural patients also exhibited higher instances of emergency department visits and hospital readmissions. Despite these challenges, survival rates and heart transplantation outcomes at 1 year were similar between rural and urban recipients. However, rural patients exhibited a higher driveline infection rate at 1 year.

Conclusion

The findings of this review suggest that rural residency may be associated with an increased risk of certain postoperative complications and hospital readmissions following LVAD implantation. These results highlight the need for healthcare strategies to address the challenges faced by rural LVAD recipients. Further research is necessary to understand the relationship between geographic location and LVAD outcomes and to develop interventions that can improve postoperative care for this vulnerable population.

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与城市LVAD接受者相比，生活在农村地区与左心室辅助装置（LVAD）植入术后并发症或再入院发生率之间是否存在关联？系统评价。

背景：左心室辅助装置（lvad）被用作终末期心力衰竭患者的治疗选择。虽然LVAD植入可以提高生存率和生活质量，但该手术有其风险，术后并发症很常见。本综述旨在探讨与城市LVAD受者相比，生活在农村地区与LVAD植入术后并发症或再入院发生率之间是否存在关联。方法：综合文献综述，比较农村和城市LVAD受者的术后结果。提取有关不良事件、住院和死亡率的数据，重点关注地理位置对这些结果的影响。结果：该综述发现，农村LVAD受者发生某些并发症的风险可能更高，包括胃肠道出血、室性心律失常、LVAD并发症和中风。农村患者也表现出更高的急诊科就诊和再入院率。尽管存在这些挑战，但农村和城市受者的1年生存率和心脏移植结果相似。然而，农村患者在1年时表现出较高的传动系统感染率。结论：本综述的研究结果表明，农村居民可能与LVAD植入后某些术后并发症和再入院风险增加有关。这些结果突出了医疗保健战略的需要，以解决农村LVAD接受者面临的挑战。进一步的研究是必要的，以了解地理位置和LVAD预后之间的关系，并制定干预措施，以改善对这一弱势群体的术后护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.