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12-04-2022 | Subdural Hematoma | Original work

Implications of Causes of Intracranial Hemorrhage During Left Ventricular Assist Device Support

Authors: Aaron Shoskes, Catherine Hassett, Aron Gedansky, Randall Carson Starling, Jerry D. Estep, Michael Z. Y. Tong, Sung-Min Cho, Ken Uchino

Published in: Neurocritical Care | Issue 1/2022

Abstract

Background

Intracranial hemorrhage (ICH) is a frequent complication in patients with an implanted left ventricular assist device (LVAD) for advanced heart failure. Bloodstream infection is known to be associated with ICH in patients with LVAD, but its effects on ICH-associated mortality are unknown. We compared characteristics and mortality of infection-associated, traumatic, and spontaneous hemorrhages.

Methods

Patients in an LVAD registry at a tertiary care center were reviewed for this cohort study. ICH included intraparenchymal hemorrhage, subarachnoid hemorrhage, and subdural hemorrhage. Hemorrhages were categorized into infectious, traumatic, and spontaneous by the presence or absence of concurrent device-associated infection or antecedent trauma.

Results

Of 683 patients with an LVAD, 73 experienced ICH (10.7%). Intraparenchymal hemorrhage was the most prevalent (72%), followed by subarachnoid hemorrhage (27%) and subdural hemorrhage (23%), with multiple concurrent hemorrhage subtypes in 16 patients (22%). Median time from implantation to ICH was shorter in spontaneous ICH than in infection-associated ICH (100 days vs. 252 days, p = 0.048). The prevalence of the different subtypes of ICH were similar between spontaneous and infection-associated ICH, and no differences were seen in mortality between the different causes of ICH.

Conclusions

Although spontaneous ICH occurred earlier after LVAD implantation than infection-associated ICH, no difference in mortality was seen between the different causes of ICH.

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Title: Implications of Causes of Intracranial Hemorrhage During Left Ventricular Assist Device Support
Authors: Aaron Shoskes
Catherine Hassett
Aron Gedansky
Randall Carson Starling
Jerry D. Estep
Michael Z. Y. Tong
Sung-Min Cho
Ken Uchino
Publication date: 12-04-2022
Publisher: Springer US
Keywords: Subdural Hematoma
Implantable Cardioverter Defibrillator
Published in: Neurocritical Care / Issue 1/2022
Print ISSN: 1541-6933
Electronic ISSN: 1556-0961
DOI: https://doi.org/10.1007/s12028-022-01494-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Implications of Causes of Intracranial Hemorrhage During Left Ventricular Assist Device Support

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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