Background:Implantable left ventricular assist devices (LVAD) have improved quality of life and survival in patients with advanced heart failure. However, LVAD-specific infections and predicting which patients will develop infections remain challenging. This study investigated whether changes in body mass index (BMI) during hospitalization following LVAD implantation are associated with LVAD-specific infections within 1 year of implantation.

Methods and Results:Patients (n=135) undergoing LVAD implantation were retrospectively divided into 2 groups based on changes in BMI from LVAD implantation to discharge: those with and without decreases in BMI. Each group was further subdivided according to baseline albumin concentrations (high [>3.7 g/dL] and low [≤3.7 g/dL]). Twenty patients developed LVAD-specific infections within 1 year. Receiver operating characteristic curve analysis resulted in a ∆BMI cut-off of less than −0.128 kg/m². In multivariate analysis, younger patients and those with decreases in BMI had significantly higher rates of LVAD-specific infection (P=0.010 and P=0.035, respectively). LVAD-specific infection rates were significantly higher for patients with low albumin and decreases in BMI than for patients with low albumin but no decrease in BMI.

Conclusions:Decreases in BMI during hospitalization after LVAD implantation and younger age were independently associated with LVAD-specific infection within 1 year. Strict patient management may be needed to avoid decreases in BMI during hospitalization after LVAD implantation, particularly in patients with low baseline albumin concentrations.

背景：植入式左心室辅助装置 (LVAD) 改善了晚期心力衰竭患者的生活质量和生存率。然而，LVAD 特异性感染和预测哪些患者会发生感染仍然具有挑战性。本研究调查了 LVAD 植入后住院期间体重指数 (BMI) 的变化是否与植入后 1 年内的 LVAD 特异性感染有关。

方法和结果：将接受 LVAD 植入的患者（n=135）根据从 LVAD 植入到出院期间 BMI 的变化，回顾性分为 2 组：有和没有 BMI 降低的患者。每组根据基线白蛋白浓度（高 [>3.7 g/dL] 和低 [≤3.7 g/dL]）进一步细分。20 名患者在 1 年内出现 LVAD 特异性感染。接受者操作特征曲线分析导致 ΔBMI 截止值小于 -0.128 kg/m ². 在多变量分析中，年轻患者和 BMI 降低的患者的 LVAD 特异性感染率显着升高（分别为 P=0.010 和 P=0.035）。低白蛋白且 BMI 降低的患者的 LVAD 特异性感染率显着高于白蛋白低但 BMI 未降低的患者。

结论： LVAD 植入后住院期间 BMI 降低和年龄较小与 1 年内 LVAD 特异性感染独立相关。可能需要严格的患者管理以避免 LVAD 植入后住院期间的 BMI 下降，尤其是在基线白蛋白浓度较低的患者中。