Perianal disease remains an understudied and difficult complication in leukemia patients.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e19016-e19016
Author(s):  
Shreya Gupta ◽  
Nirav Patil ◽  
Emily Steinhagen-Golbig ◽  
Benjamin Kent Tomlinson ◽  
Sharon Stein ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Hospital Cost ◽  
Hospital Costs ◽  
Perianal Abscess ◽  
Lymphocytic Leukemia ◽  
Operative Intervention ◽  
Perianal Disease ◽  
Categorical Variables ◽  
Continuous Variables

e19016 Background: Perianal infection is a rare and poorly understood complication of patients with acute myeloid/lymphocytic leukemia (AML/ALL). With the advancements in oncology, patients are living longer in an immunocompromised state and thus bearing the inherent problems such as infections that arise with it. Perianal infection and its management impacts patients' quality of life as well as interrupts their ongoing oncologic treatment. The optimal treatment strategy for perianal infections in this highly immunocompromised group remains unclear, as does the selection and outcomes of patients for operative intervention. The aim of this study is to identify patient characteristics associated with perianal infection and to delineate outcomes in patients that undergo operative intervention. Methods: The National Inpatient Sample (NIS) database was used to identify hospitalized patients with diagnoses of perianal abscess and AML/ALL between 2007 and 2015. Patient data were weighted to obtain national estimates. Demographics and clinical characteristics were compared between patients with and without perianal disease using Rao-Scott Chi-square test for categorical variables, and weighted simple linear regression for continuous variables. Characteristics and outcomes were compared between patients who underwent operative or non-operative management. Results: There were 12,626 (0.7%) patients with perianal disease among 1,782,778 AML/ALL patient admissions. Patients with perianal disease were more likely to be younger (43.9 (42.5 – 45.3) years, p < 0.001), male (67.4% vs 32.6%, p < 0.001) and white (65.8% vs 54.8%, p < 0.001). Length of stay (18.4 days vs 9 days, p < 0.001) and hospital cost ($54K vs $25K, p < 0.001) were higher in those with perianal disease, but there was no difference in in-hospital mortality (5.5% in those with perianal diseases vs 6.2% in those without, p = 0.150). Greater proportion of patients without perianal disease were discharged to hospice (12.6% patients without perianal disease vs 5.1% patients with perianal disease, p < 0.001). Receiving a surgical intervention did not improve outcomes with respect to in-hospital mortality (5.9% operative vs 5.4 non-operative, p = 0.596), length of stay (20.2 days vs 18.2 days, p = 0.582) or hospital cost ($67K vs $53K, p = 0.525). Conclusions: Perianal disease is a rare but distressing complication in AML/ALL patients associated with longer hospital stays and higher hospital costs. Operative intervention for perianal disease did not reduce rates of in-hospital mortality, length of stay or hospital cost but it does impact the probability of discharge to hospice. Non-operative and operative intervention both remain equivocal in changing the outcomes these patients. Further studies are required to examine these associations and determine best practices for treatment of this condition in this complex patient population.

scholarly journals 108. Impact of Accelerate Pheno System in the Management of Gram-Negative Rod Bacteremia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S69-S69
Author(s):  
Iaswarya Ganapathiraju ◽  
Amanda Bushman ◽  
Rossana Rosa Espinoza
Keyword(s):  
Length Of Stay ◽  
Blood Culture ◽  
Hospital Mortality ◽  
Culture Collection ◽  
Categorical Variables ◽  
Fisher Exact Test ◽  
Continuous Variables ◽  
Gram Negative ◽  
Stewardship Program ◽  
The Impact

Abstract Background Early pathogen identification and initiation of appropriate antimicrobial therapy is key in the management of Gram-negative rods (GNR) bloodstream infection (BSI). The Accelerate Pheno System (ACC) has been shown to reduce time to GNR identification compared to traditional culture-based methods. We aimed to determine the impact of ACC on the management of GNR BSI in the setting of a well-established antimicrobial stewardship program (ASP). Table 1 Methods ACC was introduced in our institution on February 2019. Due to issues incorporating ACC, of patients with GNR BSI, 74% had ACC done and 26% had reporting through traditional methods. This allowed for the design of a retrospective cohort study (instead of a pre-post analysis) to evaluate the association of interest. We included adult patients admitted to three affiliated hospitals in Des Moines, Iowa with BSI due to Enterobacteriales from February 2019 to February 2020. Exclusion criteria were Emergency Department visit only and death within 48 hours of blood culture collection. Primary outcomes were length of hospital stay, days to therapy optimization and in-hospital mortality. Continuous variables were compared by non-parametric methods and categorical variables were compared by Chi-square and Fisher-exact test. Logistic regression models were used to calculate odds ratio for the impact of the intervention on therapy optimization. Results A total of 268 patients were analyzed. The median length of stay among patients who had ACC done was 5.2 days (IQR 3.6–8.7) and in those on who ACC was not done it was 5.5 (IQR 3.8–8.9) (p=0.54). No differences in in-hospital mortality were found (p=0.942). Changes in therapy and missed opportunities for optimization according to whether ACC was done are shown in Table 1. Patients who had ACC done had 99% higher odds of de-escalation within 48 hours of blood culture collection compared to patients who did not have it done (95% CI 1.01–3.92; p=0.044). Conclusion In the context of hospitals with baseline short length of stay and a well-established ASP, performing ACC was associated with higher odds of de-escalation within 48 hours of blood culture collection but did not impact length of stay or mortality among patients hospitalized with GNR BSI. Disclosures All Authors: No reported disclosures

scholarly journals National Trends in Demographics and Outcomes Following Cervical Fusion for Cervical Spondylotic Myelopathy

2017 ◽  
Vol 8 (3) ◽  
pp. 244-253 ◽  
Author(s):  
Caroline E. Vonck ◽  
Joseph E. Tanenbaum ◽  
Gabriel A. Smith ◽  
Edward C. Benzel ◽  
Thomas E. Mroz ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Cervical Spondylotic Myelopathy ◽  
Hospital Charges ◽  
Categorical Variables ◽  
Cervical Fusion ◽  
Continuous Variables ◽  
Chi Square ◽  
Surgical Modality ◽  
National Trends

Study Design: Retrospective trends analysis. Objectives: Cervical fusion is a common adjunctive surgical modality used in the treatment of cervical spondylotic myelopathy (CSM). The purpose of this study was to quantify national trends in patient demographics, hospital characteristics, and outcomes in the surgical management of CSM. Methods: This was a retrospective study that used the National Inpatient Sample. The sample included all patients over 18 years of age with a diagnosis of CSM who underwent cervical fusion from 2003 to 2013. The outcome measures were in-hospital mortality, length of stay, and hospital charges. Chi-square tests were performed to compare categorical variables. Independent t tests were performed to compare continuous variables. Results: We identified 62 970 patients with CSM who underwent cervical fusion from 2003 to 2013. The number of fusions performed per year in the treatment of CSM increased from 3879 to 8181. The average age of all fusion patients increased from 58.2 to 60.6 years ( P < .001). Length of stay did not change significantly from a mean of 3.7 days. In-hospital mortality decreased from 0.6% to 0.3% ( P < .01). Hospital charges increased from $49 445 to $92 040 ( P < .001). Conclusions: This study showed a dramatic increase in cervical fusions to treat CSM from 2003 to 2013 concomitant with increasing age of the patient population. Despite increases in average age and number of comorbidities, length of stay remained constant and a decrease in mortality was seen across the study period. However, hospital charges increased dramatically.

scholarly journals Effect of anticholinergic burden on the onset of delirium in elderly hospitalized patientsassessed by 3 anticholinergic scales

2021 ◽  
Author(s):  
NGOMBENZALE GOY ◽  
JESSICA EPOUPA ◽  
JEAN-CHRISTOPHE BIER ◽  
GILLES NAEIJE ◽  
LAETITIA BEERNAERT ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Categorical Variables ◽  
Control Group ◽  
Anticholinergic Drugs ◽  
Continuous Variables ◽  
Rater Reliability ◽  
Burden Of Treatment ◽  
Significant Difference ◽  
Anticholinergic Burden

Abstract Background: Several studies have demonstrated the deleterious effects of anticholinergic drugs on the cognitive functions of the elderly. However, their effects on the onset of delirium have produced conflicting results. We assessed the association of the anticholinergic burden of treatment at admission according to 3 anticholinergic scales, the ADS, the modified ADS (mADS) and the Marante Scale on the onset of delirium in elderly hospitalized patients. We also analyzed the inter-rater reliability of the scales and their prognostic value in terms of length of stay and hospital mortality.Methods: This retrospective study included patients over 75 years of age hospitalized in medical and surgical departments between January 2014 and June 2019. Delirium was diagnosed by the Confusion Assessment Method (CAM). The anticholinergic burden was assessed by ADS, mADS and Marante Scale in patients with and without delirium.Results were reported as percentages for categorical variables and mean ± standard deviation (SD) and median [interquartile range] for continuous variables after Kolmogorov- Smirnov distribution test. Descriptive statistics were performed using paired Student t-test or Chi-square test. Spearman’s correlation was run to assess the inter-rater reliability between ADS, mADS and the Marante Scale. Results: Among the 1487 patients included, 26% developed delirium. No statistically significant difference in anticholinergic burden was observed between the delirium group and the control group, regardless of the anticholinergic scale used. The correlation coefficient was respectively 0.35 and 0.33 between ADS, mADS and the Marante Scale, and 0.97 between ADS and mADS (all p<0.001). None of the three scales were associated with length of stay, intra-hospital mortality, or one-year mortality. In multivariate analysis, ADS and mADS scores were independently associated with depression (p=0.003 and <0.0001), drug withdrawal (both p<0.001) and the number of drugs on admission (both p<0.001), and Marante Scale score was independently associated with living in a nursing home (p=0.018) and the number of drugs on admission (p<0.0001).Conclusions: Regardless of the scale used, we did not demonstrate a significant association between the anticholinergic burden of treatment upon admission and the onset of delirium during hospitalization.

The in-hospital outcomes of the use of microaxial left ventricular assist device vs intra-aortic ballon pump in acute myocardial infarction complicated by cardiogenic shock

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Jin ◽  
Y Yang ◽  
B Liu
Keyword(s):  
Cardiac Arrest ◽  
Blood Transfusion ◽  
Length Of Stay ◽  
Propensity Score ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Left Ventricular ◽  
Bleeding Complications ◽  
Categorical Variables ◽  
Cardiac Complications

Abstract Purpose To compare the outcomes of patients with AMI underwent percutaneous coronary intervention (PCI) complicated by cardiogenic shock treated with IABP vs MLVAD. Methods The Nationwide Inpatient Sample (NIS) database is the largest inpatient registry in the U.S. We used NIS year 2009–2014 to identify adult patients admitted for AMI, who received PCI and complicated by cardiogenic shock. Based on the use of IABP or MLVAD, the study population was divided into 2 groups. To reduce selection bias, we performed propensity score matching using Kernell method. Patient characteristics, hospital characteristics, and comorbidities were matched. Logistic regression was used for categorical variables including in-hospital mortality, requirement of blood transfusion, sepsis, cardiac arrest and cardiac complications (including iatrogenic complications, hemopericardium, and cardiac tamponade). Poisson regression was used for continuous variables including length of stay and total cost. Results A total of 49837 patients were identified. With propensity score match, 34132 patients in IABP group were matched to 1430 patients in MLVAD group. Compared with MLVAD group, the IABP group had lower in-hospital mortality rates (28.29% vs 40.36%, OR 0.58 (0.42–0.81), p=0.002), lower rate of blood transfusion (9.63% vs 11.50%, OR 0.49 (0.27–0.88), p=0.017), and lower cost (47167 vs 70429 USD, p&lt;0.001). IABP and MLVAD group had similar length of stay (8.9 versus 9.3 days, p=0.882), rates of cardiac complication (6.50% vs 7.24%, OR 0.56 (0.26–1.19), p=0.134), rates of sepsis (9.30% vs 14.98%, OR 0.66 (0.38–1.14), p=0.133), and rates of cardiac arrest (37.84% vs 41.05%, OR 0.70 (0.45–1.10), p=0.123). Conclusion In patients with AMI underwent PCI and complicated by cardiogenic shock, MLAVD compared with IABP was associated with higher risk of in-hospital mortality, requirement of blood transfusion indicating presence of major bleeding complications, and cost, although study interpretation is limited by retrospective observational design. Further research is warranted to elucidate the optimal MCSD in these patients. Funding Acknowledgement Type of funding source: None

Predictors of 30-day readmission rate after total gastrectomy in patients with gastric malignancy.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16109-e16109
Author(s):  
Miguel Salazar ◽  
Estefania Gauto ◽  
Shristi Upadhyay Upadhyay Banskota ◽  
Pedro Palacios ◽  
Trilok Shrivastava ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Economic Burden ◽  
Readmission Rate ◽  
Hospital Costs ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Chi Square ◽  
Prolonged Length ◽  
Chi Square Test ◽  
Gastric Malignancy

e16109 Background: Total gastrectomy with lymph node dissection is curative for early gastric malignancy which accounts for 1.5% of cancer cases in the U.S. Readmissions are common postoperatively, and are associated with increased morbidity, mortality, hospital costs and decreased quality of life. We hence aim to identify incidence, impact and independent predictors for readmission in patients who underwent total gastrectomy in gastric malignancy. Methods: We conducted a retrospective cohort study of the 2017 National Readmission Database (NRD) of adult patients readmitted within 30 days after an index admission for total gastrectomy with a concomitant diagnosis of gastric malignancy. T-test was used for continuous variables and chi square test was used for categorical variables. Multivariate regression was used to identify predictors for unplanned readmissions. ICD 10 codes were used to identify diagnoses and procedures. Results: A total of 1,779 patients with gastric malignancy underwent total gastrectomy. The 30-day readmission rate was 18.5%. Main causes for readmission were sepsis, ventricular fibrillation, recurrent STEMI. Readmitted patients were more likely to be on chemotherapy. (40.1% vs 27.2%; P<0.01) and more likely to be discharged to a skilled facility (13.5% vs 17.9%; P<0.01). The total health care in-hospital economic burden of readmission was $6.5 million in total charges and $25 million in total costs. Independent predictors of readmission were major bleeding, respiratory failure requiring mechanical ventilation, peripheral parenteral nutrition, history of non-alcoholic hepato-steatosis, and prolonged length of stay. Conclusions: Readmissions after gastrectomy in patients with gastric malignancies are associated with lower in-hospital mortality yet pose a substantial economic burden on healthcare. The lower mortality might be explained by the relatively stable course and lower comorbidities of patients who become eligible for discharge after surgery. Further studies are suggested. Modifiable risk factors like malnutrition and sepsis warrant special attention to decrease readmissions and improve overall outcomes.[Table: see text]

scholarly journals Opioid-Induced Respiratory Depression Increases Hospital Costs and Length of Stay in Patients Recovering on the General Care Floor

2021 ◽  
Author(s):  
Ashish Khanna ◽  
Leif Saager ◽  
Sergio Bergese ◽  
Carla Jungquist ◽  
Hiroshi Morimatsu ◽  
...  
Keyword(s):  
United States ◽  
High Risk ◽  
Length Of Stay ◽  
Respiratory Depression ◽  
Economic Burden ◽  
Hospital Cost ◽  
Hospital Costs ◽  
Prediction Tool ◽  
Patients At Risk ◽  
General Care

Abstract Background: Opioid-induced respiratory depression is common on the general care floor. However, the clinical and economic burden of respiratory depression is not well-described. The PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) trial created a prediction tool to identify patients at risk of respiratory depression. The purpose of this retrospective sub-analysis was to examine healthcare utilization and hospital cost associated with respiratory depression.Methods: 1,335 patients (N=769 United States patients) enrolled in the PRODIGY trial received parenteral opioids and underwent continuous capnography and pulse oximetry monitoring. Cost data was retrospectively collected for 420 United States patients. Differences in healthcare utilization and costs between patients with and without ≥1 respiratory depression episode were determined. The impact of respiratory depression on hospital cost per patient was evaluated using a propensity weighted generalized linear model.Results: Patients with ≥1 respiratory depression episode had a longer length of stay (6.4 ± 7.8 days vs 5.0 ± 4.3 days, p=0.009) and higher hospital cost ($21,892 ± $11,540 vs $18,206 ± $10,864, p=0.002) compared to patients without respiratory depression. Patients at high risk for respiratory depression, determined using the PRODIGY risk prediction tool, who had ≥1 respiratory depression episode had higher hospital costs compared to high risk patients without respiratory depression ($21,948 ± $9,128 vs $18,474 ± $9,767, p=0.0495). Propensity weighted analysis identified 17% higher costs for patients with ≥1 respiratory depression episode (p=0.007). Length of stay significantly increased total cost, with cost increasing exponentially for patients with ≥1 respiratory depression episode as length of stay increased.Conclusions: Respiratory depression on the general care floor is associated with a significantly longer length of stay and increased hospital costs. Early identification of patients at risk for respiratory depression may reduce the incidence of respiratory depression and its associated clinical and economic burden.Trial registration: ClinicalTrials.gov, NCT02811302

scholarly journals Temporal Trend of Comorbidity and Increasing Impacts on Mortality, Length of Stay, and Hospital Costs of First Stroke in Tianjin, North of China

2021 ◽  
Author(s):  
Ruixiao Hao ◽  
Xuemei Qi ◽  
Xiaoshuang Xia ◽  
Lin Wang ◽  
Xin Li
Keyword(s):  
Length Of Stay ◽  
Hospital Mortality ◽  
Cox Regression ◽  
Hospital Costs ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Kaplan Meier ◽  
Comorbidity Burden ◽  
Hospitalization Costs ◽  
Severe Comorbidity

Abstract Purpose: Stroke patients have a high incidence of comorbidity. Our study aimed to explore the trend of comorbidity among patients with first stroke from 2010 to 2020, and the influence of comorbidity on admission mortality, length of stay and hospitalization costs.5988 eligible patients were enrolled in our study, and divided into 4 comorbidity burden groups according to Charlson comorbidity index (CCI): none, moderate, severe, very severe. Survival analysis was expressed by Kaplan - Meier curve. Cox regression model was used to analyze the effect of comorbidity on 7-day and in-hospital mortality. Generalized linear model (GLM) was used to analyze the association between comorbidity and hospitalization days and cost. Results: Compared to patients without comorbidity, those with very severe comorbidity were more likely to be male (342, 57.7%), suffer from ischemic stroke (565, 95.3%), afford higher expense (Midian, 19339.3RMB, IQR13020.7-27485.9RMB), and have a higher in-hospital mortality (60, 10.1%). From 2010 to 2020, proportion of patients with severe and very severe comorbidity increased 12.9%. The heaviest comorbidity burden increased the risk of 7-day mortality (adjusted hazard ratio, 3.51, 95% CI, 2.22-5.53) and in-hospital mortality (adjusted hazard ratio, 3.83, 95% CI, 2.70-5.45). Patients with very severe comorbidity had a 12% longer LOS and extra 27% expense than those without comorbidity.Conclusion: Comorbidity burden showed an increasing trend year in past eleven years. The heavy comorbidity burden increased in-hospital mortality, LOS, and hospitalization cost, especially in patients aged 55 years or more.

Abstract WMP12: Does IV tPA Improve Outcomes in Stroke Patients with Large Vessel Occlusions Treated with Intra-arterial Therapy?

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Joseph T Ho ◽  
Jason W Tarpley ◽  
Hsin-Fang Li
Keyword(s):  
Ischemic Stroke ◽  
Length Of Stay ◽  
Time Frame ◽  
Large Vessel ◽  
Categorical Variables ◽  
Complication Rates ◽  
Continuous Variables ◽  
Stroke Patients ◽  
Vessel Occlusion ◽  
Iv Tpa

Introduction: The benefit of endovascular therapy (IAT) for the treatment of emergent large vessel occlusion (ELVO) in stroke patients has been established. However, it is not known whether administration of IV tPA prior to IAT is beneficial in these patients. Methods: A retrospective review of ischemic stroke patients in the Providence Health & Services Get with the Guidelines (GWTG) database was performed from 01/2012 to 05/2016. The analysis was limited to patients who presented within 4.5 hours of last known well time (LKWT) and treatment included any form of IAT. End points were limited to data available in the GWTG database, including discharge mRS, discharge NIHSS, change in NIHSS from admission to discharge, and length of stay. Continuous variables were summarized using means and standard deviation while categorical variables were summarized using frequencies and percentages. To yield a more robust estimate against outliers for the time-related variables, medians and interquartile range (IQR) were computed and assessed using Wilcoxon rank sum tests. Chi-square tests and independent two-sample t-tests were used to evaluate the demographic and outcome differences for categorical and continuous variables, respectively. Results: A total of 10,868 patients with an ischemic stroke diagnosis were found in the specified time frame and presented within 4.5 hours of LKWT. Of these, 461 patients were treated with some form of IAT, 235 received IV tPA prior to IAT, 226 had IAT alone due to contraindication to IV tPA. There was no statistical difference in patient demographics, complication rates, TICI score, discharge NIHSS or mRS at discharge. There was a significantly higher NIHSS on admission (18.3 vs 16.7, p = 0.026), greater improvement in NIHSS (11.6 vs. 7.9, p=0.012), longer door to IAT (146 vs 101.5 min, p < 0.0001), and shorter length of stay (5 vs 6 days, p = 0.016) in the IV tPA group. Conclusions: These data suggest that IV tPA, when administered to eligible patients with ELVO, provided some benefit over IAT alone, even though it delayed IAT. Future prospective randomized trials are planned that may better address this question, but these results underscore the need for retrospective analysis of existing data.

Abstract TP334: Clinical Impact of Hematoma Expansion in LVAD Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Kara Melmed ◽  
David Roh ◽  
Josh Willey
Keyword(s):  
Hospital Mortality ◽  
Medical Center ◽  
Demographic Data ◽  
Similar Rate ◽  
Left Ventricular ◽  
Hematoma Expansion ◽  
Categorical Variables ◽  
Continuous Variables ◽  
Ich Score ◽  
The Impact

Background: Intracerebral hemorrhage (ICH) in left ventricular assist device (LVAD) patients is a devastating complication. Hematoma expansion (HE) is associated with poor outcomes in ICH patients, but the impact of HE on LVAD patients is not known. Prevention of HE includes rapid and complete coagulopathy reversal, adding further potential complications in LVAD patients given the inherent risk of hardware thrombosis. We aimed to define the occurrence of HE in the LVAD population and to determine the association between HE and mortality in this population. Methods: We performed a retrospective cohort study of ICH patients with preceding LVAD implantation admitted to Columbia University Irving Medical Center between Jan 2008 and April 2019. Intentionally matched ICH controls without LVADs were identified to compare rate of HE in LVAD and non LVAD patients. ICH volume was measured using ABC/2 method.We defined HE as an increase in hematoma volume of 6 ml or 33% comparing the first and last scan in 24 hours. Demographic data was compared using Pearson’s χ2 test for categorical variables and students T test and Wilcoxon rank sum test for normal and non-parametric continuous variables. The association between HE and hospital mortality in LVAD patients was examined using regression modeling after adjusting for Glasgow coma scale, age, hematoma size and location and admission INR. Results: Of605 LVAD patients, we identified 40 patients with ICH. Of these, 28 patients met the inclusion criteria. Mean (SD) age of LVAD patients was 56 (10), 29% of patients were female and the majority (81%) of LVAD patients were supported by Heartmate II. The median (interquartile range [IQR]) baseline hematoma size was 20.1 ml (8.6-46.9), median (IQR) ICH score was 1 (1-2). HE occurred in 16 (57%) patients supported by LVAD, and in 50% of patients without LVAD with no difference (p=0.6).There was an association between HE and in-hospital mortality in LVAD patients after adjusting for admission ICH score and INR (OR of 20.5, 95% CI: 1.8-232.8). Conclusions: HE is a potentially modifiable risk factor for mortality. We demonstrate that LVAD patients experience HE at a similar rate to matched controls. We show that prevention of HE with anticoagulation reversal does not increase mortality.

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