P40: The Relationship between LVAD Implant Length of Stay, Mortality & Race

Background: There remains a racial disparity in use of left ventricular assist devices (LVAD). However, the index implant outcomes of patients receiving LVADs have not been well described by race. We therefore sought to better understand the racial disparity of LVAD implantation, by determining what relationship, if any, may exist between race, implant length of stay (iLOS) and implant mortality. Methods: Utilizing the National Inpatient Sample (NIS) data from 2013 – 2019, we obtained all patients admitted to the hospital with a primary diagnosis of heart failure and a secondary diagnosis of cardiogenic shock, who then went on to receive an LVAD during that hospitalization. Annual iLOS (in days) and implant mortality (i.e., number of patients who died over all LVAD patients in a year) were examined amongst 4 racial groups: non-Hispanic white, non-Hispanic black, non-Hispanic other, and Hispanic. Mortality data were reported for white and black patients only due to small sample sizes for the non-Hispanic other and Hispanic patients. Results: Both iLOS and implant mortality were noted to have year-to-year variable across all racial groups. When examined as a linear relationship, iLOS was similar for all racial groups (Fig 1). There was a similar decrease in the linear trend of implant mortality for both white and black patients (Fig 2). There was no clear relationship between race and either iLOS or implant mortality trends. Conclusion: Despite the persistent racial disparity in LVAD implantation, race does not appear to have a significant relationship with index implant outcomes with overall trends evolving similarly across groups. Higher fidelity data sources and more detailed investigation is required to better explore any potential relationships.