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Infectious complications associated with short-term mechanical circulatory support in urgent heart transplant candidates.
Rev Esp Cardiol (Engl Ed). 2021 Feb 26 [Online ahead of print]RE

Abstract

INTRODUCTION AND OBJECTIVES

Short-term mechanical circulatory support is frequently used as a bridge to heart transplant in Spain. The epidemiology and prognostic impact of infectious complications in these patients are unknown.

METHODS

Systematic description of the epidemiology of infectious complications and analysis of their prognostic impact in a multicenter, retrospective registry of patients treated with short-term mechanical devices as a bridge to urgent heart transplant from 2010 to 2015 in 16 Spanish hospitals.

RESULTS

We studied 249 patients, of which 87 (34.9%) had a total of 102 infections. The most frequent site was the respiratory tract (n=47; 46.1%). Microbiological confirmation was obtained in 78 (76.5%) episodes, with a total of 100 causative agents, showing a predominance of gram-negative bacteria (n=58, 58%). Compared with patients without infection, those with infectious complications showed higher mortality during the support period (25.3% vs 12.3%, P=.009) and a lower probability of receiving a transplant (73.6% vs 85.2%, P=.025). In-hospital posttransplant mortality was similar in the 2 groups (with infection: 28.3%; without infection: 23.4%; P=.471).

CONCLUSIONS

Patients supported with temporary devices as a bridge to heart transplant are exposed to a high risk of infectious complications, which are associated with higher mortality during the organ waiting period.

Authors+Show Affiliations

Servicio de Medicina Intensiva, Complejo Hospitalario Universitario A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.Servicio de Cardiología, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain.Unidad de Insuficiencia Cardiaca y Trasplante, Servicio de Cardiología, Hospital Universitari i Politècnic La Fe, Universitat de Valencia, Valencia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain.Servicio de Cardiología, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain.Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.Servicio de Cardiología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario 12 de Octubre, Fundación de Investigación I+12, Madrid, Spain; Departamento de Medicina, Universidad Complutense de Madrid, Madrid, Spain.Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Clínic i Provincial, Barcelona, Spain.Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Complejo Hospitalario Universitario A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Sevilla, Spain.Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Universidad Europea, Madrid, Spain.Servicio de Cirugía Cardiaca, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.Servicio de Cardiología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.Servicio de Cardiología, Hospital Universitario Miguel Servet, Zaragoza, Spain.Servicio de Cirugía Cardiovascular, Hospital Universitario Reina Sofía, Córdoba, Spain.Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain.Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Departamento de Ciencias de la Salud, Universidade da Coruña, Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain.Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Complejo Hospitalario Universitario A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain. Electronic address: eduardo.barge.caballero@sergas.es.

Pub Type(s)

Journal Article

Language

eng spa

PubMed ID

33648882

Citation

Solla-Buceta, Miguel, et al. "Infectious Complications Associated With Short-term Mechanical Circulatory Support in Urgent Heart Transplant Candidates." Revista Espanola De Cardiologia (English Ed.), 2021.
Solla-Buceta M, González-Vílchez F, Almenar-Bonet L, et al. Infectious complications associated with short-term mechanical circulatory support in urgent heart transplant candidates. Rev Esp Cardiol (Engl Ed). 2021.
Solla-Buceta, M., González-Vílchez, F., Almenar-Bonet, L., Lambert-Rodríguez, J. L., Segovia-Cubero, J., González-Costello, J., Delgado, J. F., Pérez-Villa, F., Crespo-Leiro, M. G., Rangel-Sousa, D., Martínez-Sellés, M., Rábago-Juan-Aracil, G., De-la-Fuente-Galán, L., Blasco-Peiró, T., Hervás-Sotomayor, D., Garrido-Bravo, I. P., Mirabet-Pérez, S., Muñiz, J., & Barge-Caballero, E. (2021). Infectious complications associated with short-term mechanical circulatory support in urgent heart transplant candidates. Revista Espanola De Cardiologia (English Ed.). https://doi.org/10.1016/j.rec.2020.11.019
Solla-Buceta M, et al. Infectious Complications Associated With Short-term Mechanical Circulatory Support in Urgent Heart Transplant Candidates. Rev Esp Cardiol (Engl Ed). 2021 Feb 26; PubMed PMID: 33648882.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Infectious complications associated with short-term mechanical circulatory support in urgent heart transplant candidates. AU - Solla-Buceta,Miguel, AU - González-Vílchez,Francisco, AU - Almenar-Bonet,Luis, AU - Lambert-Rodríguez,José Luis, AU - Segovia-Cubero,Javier, AU - González-Costello,José, AU - Delgado,Juan F, AU - Pérez-Villa,Félix, AU - Crespo-Leiro,María G, AU - Rangel-Sousa,Diego, AU - Martínez-Sellés,Manuel, AU - Rábago-Juan-Aracil,Gregorio, AU - De-la-Fuente-Galán,Luis, AU - Blasco-Peiró,Teresa, AU - Hervás-Sotomayor,Daniela, AU - Garrido-Bravo,Iris P, AU - Mirabet-Pérez,Sonia, AU - Muñiz,Javier, AU - Barge-Caballero,Eduardo, Y1 - 2021/02/26/ PY - 2020/06/16/received PY - 2020/11/11/accepted PY - 2021/3/2/entrez PY - 2021/3/3/pubmed PY - 2021/3/3/medline KW - Asistencia circulatoria mecánica KW - Asistencia ventricular KW - Critical care KW - Cuidados críticos KW - ECMO KW - Heart transplant KW - Infección KW - Infection KW - Mechanical circulatory support KW - Trasplante cardiaco KW - Ventricular assist device JF - Revista espanola de cardiologia (English ed.) JO - Rev Esp Cardiol (Engl Ed) N2 - INTRODUCTION AND OBJECTIVES: Short-term mechanical circulatory support is frequently used as a bridge to heart transplant in Spain. The epidemiology and prognostic impact of infectious complications in these patients are unknown. METHODS: Systematic description of the epidemiology of infectious complications and analysis of their prognostic impact in a multicenter, retrospective registry of patients treated with short-term mechanical devices as a bridge to urgent heart transplant from 2010 to 2015 in 16 Spanish hospitals. RESULTS: We studied 249 patients, of which 87 (34.9%) had a total of 102 infections. The most frequent site was the respiratory tract (n=47; 46.1%). Microbiological confirmation was obtained in 78 (76.5%) episodes, with a total of 100 causative agents, showing a predominance of gram-negative bacteria (n=58, 58%). Compared with patients without infection, those with infectious complications showed higher mortality during the support period (25.3% vs 12.3%, P=.009) and a lower probability of receiving a transplant (73.6% vs 85.2%, P=.025). In-hospital posttransplant mortality was similar in the 2 groups (with infection: 28.3%; without infection: 23.4%; P=.471). CONCLUSIONS: Patients supported with temporary devices as a bridge to heart transplant are exposed to a high risk of infectious complications, which are associated with higher mortality during the organ waiting period. SN - 1885-5857 UR - https://www.unboundmedicine.com/medline/citation/33648882/Infectious_complications_associated_with_short-term_mechanical_circulatory_support_in_urgent_heart_transplant_candidates. L2 - http://www.revespcardiol.org/en/linksolver/ft/pii/S1885-5857(21)00049-9 DB - PRIME DP - Unbound Medicine ER -