Association of Pre-Implant Red Blood Cell Distribution Width with Clinical Outcomes Among Individuals with Left Ventricular Assist Devices: LVAD Red Blood Cell Distribution and Mortality

Elliott E. Miller, Brian A. Houston, Andrea L C Schneider, Aaron Bush, Glenn Whitman, Gerin Stevens, Ryan J. Tedford, Stuart D. Russell

Research output: Contribution to journalArticle

Abstract

Left ventricular assist devices (LVADs) are increasingly used for end-stage heart failure. However, post-LVAD complications are potentially devastating and remain unpredictable. The red blood cell distribution width (RDW) is a predictor of adverse events in patients with heart failure, but has not been studied in the LVAD population. We reviewed laboratory results and clinical outcomes for all continuous flow LVADs implanted from 2004 to June 2014 (N=188). Cox proportional hazards models adjusted for demographic, cardiovascular, and laboratory variables were used to assess association of pre-implant RDW tertiles with mortality, GI bleed, infection, pump thrombosis, and stroke over 1-year of follow-up. Compared to the lowest tertile (RDW < 15.7%), the higher two tertiles (RDW 15.7-18% and RDW >18.1%) had significantly higher risks of mortality (HR 6.95 [CI: 2.67-18.10]) and HR 4.61 [1.74-12.21] respectively) after full adjustment. Pre-implant RDW was not statistically associated with our secondary outcomes. In conclusion, higher pre-implant RDW is independently associated with an increased risk of post-implant mortality and infection. Future studies are needed to understand the prognostic ability of RDW and to understand the biologic mechanism underlying this association.

Original languageEnglish (US)
JournalASAIO Journal
DOIs
StateAccepted/In press - Aug 22 2016

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ASJC Scopus subject areas

  • Bioengineering
  • Biophysics
  • Medicine(all)
  • Biomaterials
  • Biomedical Engineering

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