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Obesity Is Associated with Driveline Infection of Left Ventricular Assist Devices

Akay, Mehmet H.*; Nathan, Sriram S.*; Radovancevic, Rajko*; Poglajen, Gregor*,†; Jezovnik, Mateja K.*; Candelaria, Isabella N.*; Averill, Barbara L.*; Patel, Manish K.*; Kar, Biswajit*; Gregoric, Igor D.*

doi: 10.1097/MAT.0000000000000916
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In patients with left ventricular assist devices (LVADs), the association of driveline infection (DLI) and body mass index (BMI) remains controversial. The aim of this study was to explore a potential correlation between BMI and DLI in the LVAD patient population. A retrospective, single-center study evaluated patients who underwent LVAD implantation between May 2012 and July 2016. Driveline infection was evaluated per Interagency Registry for Mechanically Assisted Circulatory Support established criteria. Of 222 included patients, 80% were male, the average age was 55 years, and the main underlying heart failure diagnosis was nonischemic cardiomyopathy (56%). The majority of patients (65%) received LVAD as destination therapy and 35% as a bridge to transplantation. Average time-to-first DLI was 296 days after LVAD implantation. In comparison to non-DLI group (80%, N = 177), patients in DLI group (20%, N = 45) had a higher BMI (33.5 ± 8.3 kg/m2 in DLI group vs. 28.8 ± 7.5 kg/m2 in non-DLI group, p = 0.0003) and were younger (51 ± 12 years in DLI group vs. 56 ± 12 years in non-DLI group, p = 0.013). There was a significant correlation between BMI and DLI (p < 0.0001), and age was negatively correlated with DLI (p = 0.01). Analysis revealed no correlation between time-to-first DLI and BMI. Our data confirm that higher BMI is associated with increased prevalence of DLI in LVAD population, particularly in younger patients. Addressing excessive body weight in this patient cohort may significantly reduce DLI and thereby improve long-term outcomes.

From the *Department of Advanced Cardiopulmonary Therapies and Transplantation, University of Texas-Houston McGovern Medical School and Memorial Hermann-Texas Medical Center, Houston, Texas

Advanced Heart Failure and Transplantation Center, University Medical Center Ljubljana, Ljubljana, Slovenia.

Submitted for consideration March 2018; accepted for publication in revised form October 2018.

Disclosure: The authors have no conflicts of interest to report.

Correspondence: Igor D. Gregoric, 6400 Fannin St, Suite 2350 Houston, TX 77030. Email: Igor.D.Gregoric@uth.tmc.edu.

Copyright © 2019 by the American Society for Artificial Internal Organs