Heart failure & cardiomyopathiesCohort study

Association Between Caseload Volume and Outcomes in Left Ventricular Assist Device Implantations – a EUROMACS Analysis

Eur J Heart FailPublished

  • Retrospective registry cohort study
  • multicentre

Authors' conclusion

In patients undergoing LVAD implantation, centre volume was not associated with 1-year survival, but was related to device-related adverse events. Patient profiles differed with respect to centre size.

Study context

Population
Patients undergoing left ventricular assist device (LVAD) implantation, EUROMACS registry, 35 centres, 2011–2020
Participants
4,802 patients · 35 centres
Exposure
Higher-volume vs lower-volume centres
Outcome
1-year survival
Follow-up
1 year

Main finding

As reported in the abstract

Adjusted 1-year survival
  • No difference in adjusted 1-year survival

Observational data: associations, not effects.

Secondary outcomes

Outcomeadjusted OR (95% CI)P value
1-year survival, HeartMate 3 devices only (subgroup)0.43 (0.20–0.97)P = 0.041

Adjusted overall survival

Adjusted overall survival probability lower in higher volume centres
P = 0.002
  • median follow-up 1.54 years (IQR 0.52-3.15)

Cumulative (learning curve) caseload analyses

Similar findings observed

Original publication

Association Between Caseload Volume and Outcomes in Left Ventricular Assist Device Implantations – a EUROMACS Analysis. Eur J Heart Fail. Published 29 August 2024. doi:10.1002/ejhf.3418

Summarised from the published abstract; every number is checked against it