Background: Early readmissions contribute significantly to heart failure–related morbidity and negatively affect quality of life. Data on left ventricular assist device (LVAD)–related 30-day readmissions are scarce and limited to small studies.

Methods and Results: Patients undergoing LVAD implantation between January 2013 and November 2014 who survived the index hospitalization were identified in the Nationwide Readmissions Database. We analyzed the incidence, predictors, causes, and costs of 30-day readmissions. Of 2510 LVAD recipients, 788 (31%) were readmitted within 30 days. Length of index hospitalization ≥31 days (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.07–1.50) and female sex (HR, 1.19; 95% CI, 1.01–1.42) were associated with a higher risk of 30-day readmission, whereas private insurance (HR, 0.83; 95% CI, 0.70–0.99), pre-LVAD use of short-term mechanical circulatory support (HR, 0.53; 95% CI, 0.29–0.98), and discharge to a short-term hospital facility (HR, 0.41; CI, 0.21–0.78) were associated with a lower risk. Cardiac causes accounted for 23.8% of readmissions: heart failure (13.4%) and arrhythmias (8.1%). Noncardiovascular causes accounted for 76.2% of readmissions: infection (30.2%), bleeding (17.6%), and device-related causes (8.2%). Mean length of stay for readmission was 10.7 days (median, 6 days), and average hospital cost per readmission was $34 948±2457.

Conclusions: Early readmissions are frequent after LVAD implantation even in contemporary times. Preimplant identification of high-risk patients, and a protocol-driven follow-up using a multidisciplinary approach will be needed to reduce readmissions and improve outcomes.

背景：早期再次入院会大大增加与心力衰竭相关的发病率，并对生活质量产生负面影响。与左心室辅助装置（LVAD）相关的30天再入院率的数据很少，并且仅限于小型研究。

方法和结果：2013年1月至2014年11月之间接受LVAD植入的患者在指数住院后幸存下来，并在全国再入院数据库中进行了识别。我们分析了30天再入院的发生率，预测因素，原因和成本。在2510位LVAD接受者中，有788位（31％）在30天内被重新接纳。指数住院时间≥31天（危险比[HR]，1.26； 95％置信区间[CI]，1.07-1.50）和女性（HR，1.19； 95％CI，1.01-1.42）与较高的风险相关30天再入院率，而私人保险（HR，0.83； 95％CI，0.70-0.99），LVAD前使用短期机械循环支持（HR，0.53； 95％CI，0.29-0.98）和出院短期医院（HR，0.41； CI，0.21-0.78）与较低的风险相关。心脏原因占再入院率的23.8％：心力衰竭（13。4％）和心律不齐（8.1％）。非心血管原因占再入院率的76.2％：感染（30.2％），出血（17.6％）和与器械相关的原因（8.2％）。再入院的平均住院时间为10.7天（中位数为6天），每次再入院的平均住院费用为$ 34 948±2457。

结论：即使在当代，LVAD植入后的早期再次入院也很常见。需要高风险患者的植入前识别，以及采用多学科方法进行方案指导的随访，以减少再次入院并改善预后。