Substantial Reduction in Driveline Infection Rates With the Modification of Driveline Dressing Protocol.
J Card Fail
; 24(11): 746-752, 2018 Nov.
Article
in En
| MEDLINE
| ID: mdl-30098380
ABSTRACT
BACKGROUND:
Driveline infection (DLI) is a cause of morbidity and mortality in patients with continuous-flow left ventricular assist devices (CF-LVADs). We hypothesized that an alternate dressing protocol would decrease the rate of DLIs. METHODS ANDRESULTS:
A retrospective review of CF-LVAD implants at a single institution from January 2010 to October 2015 was conducted. Patients were divided into implants before (group 1) and after (group 2) the introduction of the new protocol on September 1, 2012. Patients were followed until death, transplantation, change in dressing type, or 2 years. 153 patients were included 61 in group 1 and 92 in group 2. Group 1 had fewer HVADs than group 2 (27.9% vs 71.7%; P < .001) and more destination therapy, although the latter was not statistically significant (50.8% vs 34.8%; Pâ¯=â¯.118). At 24 months, the freedom from DLI was 53% in group 1 and 89% in group 2 (Pâ¯=â¯.01). Group 1 had a significantly greater risk of DLI than group 2 (incident rate ratio 3.18, 95% confidence interval 1.23-8.18; Pâ¯=â¯.016).CONCLUSIONS:
Dramatic improvement in freedom from DLI at 2 years was achieved with a new driveline dressing protocol. This demonstrates that DLI rates can be improved with alternate percutaneous site care techniques in CF-LVAD patients.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Bandages
/
Clinical Protocols
/
Heart-Assist Devices
/
Prosthesis-Related Infections
/
Heart Failure
Type of study:
Guideline
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
J Card Fail
Journal subject:
CARDIOLOGIA
Year:
2018
Type:
Article