Preoperative Prealbumin Level as a Predictor of Outcomes in Patients Who Underwent Left Ventricular Assist Device Implantation

Andre C. Critsinelis, Chitaru Kurihara, Masashi Kawabori, Tadahisa Sugiura, Andrew B. Civitello, Jeffrey A. Morgan

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Malnutrition has been associated with an increased risk of morbidity and mortality in patients who undergo cardiac surgery. However, many measurements of malnutrition have been inadequate prognostic markers. In this study, we sought to determine whether low preoperative serum prealbumin level was associated with morbidity and mortality in patients who underwent continuous-flow left ventricular assist device (CF-LVAD) implantation. From November 2003 to March 2016, 526 patients with chronic heart failure underwent implantation of a CF-LVAD (HeartMate II, n = 403; HeartWare HVAD, n = 123). Our cohort comprised the 317 CF-LVAD recipients whose records included the preoperative serum prealbumin level. These patients were divided into 2 groups: those with a normal preoperative serum prealbumin level (>17 g/dL) and those with hypoprealbuminemia (≤17 g/dL). These groups were then compared with regard to preoperative demographics, incidence of postoperative complications, long-term survival rate, and cause of death. Kaplan-Meier survival analysis revealed that patients with a low preoperative prealbumin level had significantly decreased survival rates at 1, 6, 12, and 24 months (p <0.001) after CF-LVAD implantation and higher overall mortality (p = 0.04) than the patients with a normal prealbumin level, and that exacerbated heart failure made up the majority of this difference within the first 6 months. However, we found no significant correlations between low prealbumin level and postoperative complications. In conclusion, our findings demonstrate that preoperative serum prealbumin levels predict patient outcomes after CF-LVAD implantation.

Original languageEnglish (US)
Pages (from-to)1998-2002
Number of pages5
JournalAmerican Journal of Cardiology
Volume120
Issue number11
DOIs
StatePublished - Dec 1 2017
Externally publishedYes

Fingerprint

Prealbumin
Heart-Assist Devices
Serum
Malnutrition
Mortality
Survival Rate
Heart Failure
Morbidity
Kaplan-Meier Estimate
Survival Analysis
Thoracic Surgery
Cause of Death
Demography
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Preoperative Prealbumin Level as a Predictor of Outcomes in Patients Who Underwent Left Ventricular Assist Device Implantation. / Critsinelis, Andre C.; Kurihara, Chitaru; Kawabori, Masashi; Sugiura, Tadahisa; Civitello, Andrew B.; Morgan, Jeffrey A.

In: American Journal of Cardiology, Vol. 120, No. 11, 01.12.2017, p. 1998-2002.

Research output: Contribution to journalArticle

Critsinelis, Andre C. ; Kurihara, Chitaru ; Kawabori, Masashi ; Sugiura, Tadahisa ; Civitello, Andrew B. ; Morgan, Jeffrey A. / Preoperative Prealbumin Level as a Predictor of Outcomes in Patients Who Underwent Left Ventricular Assist Device Implantation. In: American Journal of Cardiology. 2017 ; Vol. 120, No. 11. pp. 1998-2002.
@article{10401a3eaf254a0ca9fd40bbf12035af,
title = "Preoperative Prealbumin Level as a Predictor of Outcomes in Patients Who Underwent Left Ventricular Assist Device Implantation",
abstract = "Malnutrition has been associated with an increased risk of morbidity and mortality in patients who undergo cardiac surgery. However, many measurements of malnutrition have been inadequate prognostic markers. In this study, we sought to determine whether low preoperative serum prealbumin level was associated with morbidity and mortality in patients who underwent continuous-flow left ventricular assist device (CF-LVAD) implantation. From November 2003 to March 2016, 526 patients with chronic heart failure underwent implantation of a CF-LVAD (HeartMate II, n = 403; HeartWare HVAD, n = 123). Our cohort comprised the 317 CF-LVAD recipients whose records included the preoperative serum prealbumin level. These patients were divided into 2 groups: those with a normal preoperative serum prealbumin level (>17 g/dL) and those with hypoprealbuminemia (≤17 g/dL). These groups were then compared with regard to preoperative demographics, incidence of postoperative complications, long-term survival rate, and cause of death. Kaplan-Meier survival analysis revealed that patients with a low preoperative prealbumin level had significantly decreased survival rates at 1, 6, 12, and 24 months (p <0.001) after CF-LVAD implantation and higher overall mortality (p = 0.04) than the patients with a normal prealbumin level, and that exacerbated heart failure made up the majority of this difference within the first 6 months. However, we found no significant correlations between low prealbumin level and postoperative complications. In conclusion, our findings demonstrate that preoperative serum prealbumin levels predict patient outcomes after CF-LVAD implantation.",
author = "Critsinelis, {Andre C.} and Chitaru Kurihara and Masashi Kawabori and Tadahisa Sugiura and Civitello, {Andrew B.} and Morgan, {Jeffrey A.}",
year = "2017",
month = "12",
day = "1",
doi = "10.1016/j.amjcard.2017.08.004",
language = "English (US)",
volume = "120",
pages = "1998--2002",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "11",

}

TY - JOUR

T1 - Preoperative Prealbumin Level as a Predictor of Outcomes in Patients Who Underwent Left Ventricular Assist Device Implantation

AU - Critsinelis, Andre C.

AU - Kurihara, Chitaru

AU - Kawabori, Masashi

AU - Sugiura, Tadahisa

AU - Civitello, Andrew B.

AU - Morgan, Jeffrey A.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Malnutrition has been associated with an increased risk of morbidity and mortality in patients who undergo cardiac surgery. However, many measurements of malnutrition have been inadequate prognostic markers. In this study, we sought to determine whether low preoperative serum prealbumin level was associated with morbidity and mortality in patients who underwent continuous-flow left ventricular assist device (CF-LVAD) implantation. From November 2003 to March 2016, 526 patients with chronic heart failure underwent implantation of a CF-LVAD (HeartMate II, n = 403; HeartWare HVAD, n = 123). Our cohort comprised the 317 CF-LVAD recipients whose records included the preoperative serum prealbumin level. These patients were divided into 2 groups: those with a normal preoperative serum prealbumin level (>17 g/dL) and those with hypoprealbuminemia (≤17 g/dL). These groups were then compared with regard to preoperative demographics, incidence of postoperative complications, long-term survival rate, and cause of death. Kaplan-Meier survival analysis revealed that patients with a low preoperative prealbumin level had significantly decreased survival rates at 1, 6, 12, and 24 months (p <0.001) after CF-LVAD implantation and higher overall mortality (p = 0.04) than the patients with a normal prealbumin level, and that exacerbated heart failure made up the majority of this difference within the first 6 months. However, we found no significant correlations between low prealbumin level and postoperative complications. In conclusion, our findings demonstrate that preoperative serum prealbumin levels predict patient outcomes after CF-LVAD implantation.

AB - Malnutrition has been associated with an increased risk of morbidity and mortality in patients who undergo cardiac surgery. However, many measurements of malnutrition have been inadequate prognostic markers. In this study, we sought to determine whether low preoperative serum prealbumin level was associated with morbidity and mortality in patients who underwent continuous-flow left ventricular assist device (CF-LVAD) implantation. From November 2003 to March 2016, 526 patients with chronic heart failure underwent implantation of a CF-LVAD (HeartMate II, n = 403; HeartWare HVAD, n = 123). Our cohort comprised the 317 CF-LVAD recipients whose records included the preoperative serum prealbumin level. These patients were divided into 2 groups: those with a normal preoperative serum prealbumin level (>17 g/dL) and those with hypoprealbuminemia (≤17 g/dL). These groups were then compared with regard to preoperative demographics, incidence of postoperative complications, long-term survival rate, and cause of death. Kaplan-Meier survival analysis revealed that patients with a low preoperative prealbumin level had significantly decreased survival rates at 1, 6, 12, and 24 months (p <0.001) after CF-LVAD implantation and higher overall mortality (p = 0.04) than the patients with a normal prealbumin level, and that exacerbated heart failure made up the majority of this difference within the first 6 months. However, we found no significant correlations between low prealbumin level and postoperative complications. In conclusion, our findings demonstrate that preoperative serum prealbumin levels predict patient outcomes after CF-LVAD implantation.

UR - http://www.scopus.com/inward/record.url?scp=85029785515&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85029785515&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2017.08.004

DO - 10.1016/j.amjcard.2017.08.004

M3 - Article

C2 - 28958451

AN - SCOPUS:85029785515

VL - 120

SP - 1998

EP - 2002

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 11

ER -