The objective of this study was to assess the frequency of neurological complications in left ventricular assist device (LVAD) patients.

LVAD is an increasingly used technique to improve survival and quality of life in refractory end stage heart failure patients. The impact of neurologic complications of patients receiving LVAD is poorly understood.

All patients receiving LVAD were selected from the Nationwide Inpatient Sample from 2006–2014. The rates and outcomes of neurologic complications [acute ischemic stroke, intracranial hemorrhage (ICH), subarachnoid hemorrhage (SAH) and seizures] were determined. Discharge status, mortality, length of stay and hospitalization costs were compared between patients with and without neurologic complications using chi-squared tests for categorical variables and Student’s t-test for continuous variables.

In 17,735 of total patients, 1,344 (7.6%) suffered neurologic complications of ischemic stroke 829 (4.67%), SAH 58 (0.39%, ICH 218 (1.23%) and seizures 239 (1.35%). Surprisingly, acute ischemic stroke patients had significantly shorter mean length of stay (28.4 vs. 33.1 days, p<0.0001) and lower hospital costs (625775$ vs. 731220$, p<0.0001) compared to patients without neurologic complications. ICH patients had significantly lower rates of discharge to home (20.5% vs. 67.1%, p<0.0001), significantly higher mortality rates (63.5% vs. 13.1%, p<0.0001), and a significantly longer mean length of stay (53.2 vs. 33.1 days, p<0.0001) compared to patients without neurologic complications. These outcomes did not differ significantly between seizure patients and patients without neurologic complications.

Given the increasing utilization of LVAD and poor outcomes associated with neurologic complications, more research is needed to individualize the treatment on patient basis to prevent these complications.