Are blood stream infections associated with an increased risk of hemorrhagic stroke in patients with a left ventricular assist device?

Ashim Aggarwal, Ankit Gupta, Shivani Kumar, Jane A. Baumblatt, Sunil Pauwaa, Colleen Gallagher, Adam Treitman, Pat Pappas, Antone Tatooles, Geetha Bhat

Research output: Contribution to journalReview article

43 Scopus citations

Abstract

Blood stream infections (BSIs) are an important cause of morbidity and mortality in patients with left ventricular assist devices (LVADs). The aim of this study was to examine the correlation between hemorrhagic cerebrovascular accident (CVA) and BSI after implantation of LVAD for advanced heart failure (HF). This was a retrospective descriptive review of 87 patients with end-stage HF, who underwent implantation of HeartMate II continuous-flow LVAD over a 4 year period. Blood stream infections were diagnosed by serial blood cultures, and suspected neurological complications including CVAs were confirmed by neuroimaging. Extensive patient chart review was performed, and descriptive characteristics were analyzed using SPSS statistical software. The mean age of our study population was 62.3 ± 12.8 years, and the majority of our patients were males (n = 75, 86.2%). The baseline characteristics were comparable in the patients with and without CVAs. Patients with BSI had a much greater incidence of CVA compared to patients without BSI (n = 13, 43.3% vs. n = 5, 10.0%; p < 0.0001). There was an increased mortality in patients with BSI than those without (n = 57, 65.5% vs. n = 30, 34.5%; p = 0.003). The risk of all CVAs (hemorrhagic/ischemic) was eightfold (odds ratio [OR] = 7.9; 95% confidence interval [CI] = 2.4-25.5; p = 0.001] in patients with BSI. Patients with BSI had a >20-fold risk of hemorrhagic CVA (OR = 24; 95% CI = 2.8-201.1; p = 0.03). Advanced HF patients with LVAD support who developed BSI need urgent evaluation and close monitoring for suspected neurological complications, particularly hemorrhagic CVA.

Original languageEnglish (US)
Pages (from-to)509-513
Number of pages5
JournalASAIO Journal
Volume58
Issue number5
DOIs
StatePublished - Sep 1 2012

    Fingerprint

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

Cite this

Aggarwal, A., Gupta, A., Kumar, S., Baumblatt, J. A., Pauwaa, S., Gallagher, C., Treitman, A., Pappas, P., Tatooles, A., & Bhat, G. (2012). Are blood stream infections associated with an increased risk of hemorrhagic stroke in patients with a left ventricular assist device? ASAIO Journal, 58(5), 509-513. https://doi.org/10.1097/MAT.0b013e318260c6a6