3.1. Time trends in utilization, mortality, cost, and LOS among
BiVAD patients
Between 2009 and 2015, there was an overall decline in the utilization
of all BiVADs (-4.8% per year, p < 0.001, see Figure
1). There was a significant increase in the use of internal BiVADs
(+10.0% per year, p < 0.001, see Figure 1) and a
significant decrease in the use of external BiVADs (-9.4% per year,p < 0.001, see Figure 1). There were no significant
changes in mortality for all BiVADs, internal BiVADs, or external BiVADs
(see Appendix A). The costs associated with BiVAD implantation increased
significantly (+23.0% per year, p <0.001). The LOS
also had an increasing trend, although not significant (p =
0.083, see Figure 2). Among complications associated with BiVAD
implantations, the rates of hemoperitoneum (p = 0.003),
gastrointestinal (GI) bleed (p = 0.001), and acute renal failure
(p = 0.008) increased significantly over time (see Table 2).
Among known comorbidities, CAD (p = 0.006), MI (p =
0.010), fluid and electrolyte disorders (p = 0.043), and history
of renal failure (p = 0.011) increased over time (see Table 2).