3.3 Comparisons between internal and external BiVADs:
utilization, mortality, LOS, cost, and complications
Internal BiVADs were implanted in 538 (42.5%) patients and external
BiVADs in 727 (57.5%) patients (see Table 3). More patients were female
in the external BiVAD group (30.1% vs 18.4%, p = 0.024). There
were no significant differences between internal and external BiVADs in
insurance coverage, size, and teaching status of the hospitals, as well
as elective cases. More of the external BiVAD implantation occurred in
the Northeast compared to the internal BiVADs (36.0% vs. 14.9%,p = 0.002). Internal BiVAD implantations were more likely than
external BiVAD implantations to take place in urban teaching hospitals
(98.3% vs. 90.3%, p < 0.001). Significantly more
patients in the external BiVAD group had documented history of CAD
(44.9% vs. 22.1%, p < 0.001), pulmonary circulatory
disorders (5.3% vs 0, p = 0.014), and valvular disease (7.2%
vs. 0, p = 0003). History of renal failure was more prevalent in
the internal BiVAD group (36.1% vs. 16.1%, p <
0.001).
Higher mortality was observed among patients with external BiVADs
compared to those with internal BiVADs (59.1% vs. 45.4%, p =
0.022, see Table 3). Internal BiVADs were associated with longer median
LOS (64.0 vs. 20.0 days, p < 0.001) and higher cost
($468,321 vs. $208,809 per hospitalization, p <
0.001). There were more complications of acute renal failure (85.6% vs.
74.0%, p = 0.020) and hemolytic anemia (4.5% vs. 0.7%,p = 0.038) among those with internal BiVADs. There were no
significant differences in rates of bleeding, infection, or stroke.