Evidence map›Paper›PMID 40627235›Full record

ArticleEmergency radiology2025

Identifying key CT features and clinical variables for predicting operative management of left ventricular assist device (LVAD) driveline infections.

Mahati Mokkarala, Aravinda Ganapathy, Yuktesh Kalidindi, Chelsea R Schmitt, Mark J Hoegger, Ryan G Short, Demetrios A Raptis, David H Ballard

Abstract read
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Article in Emergency radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Infections in mechanical circulatory support.Frontiers in cardiovascular medicine · 2026
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mahati MokkaralaMallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus 8131, St. Louis, MO, 63110, USA.
Aravinda GanapathyMallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus 8131, St. Louis, MO, 63110, USA.
Yuktesh KalidindiSchool of Medicine, Saint Louis University, St. Louis, MO, 63104, USA.
Chelsea R SchmittMallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus 8131, St. Louis, MO, 63110, USA.
Mark J HoeggerMallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus 8131, St. Louis, MO, 63110, USA.
Ryan G ShortMallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus 8131, St. Louis, MO, 63110, USA.
Demetrios A RaptisMallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus 8131, St. Louis, MO, 63110, USA.
David H BallardMallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, Campus 8131, St. Louis, MO, 63110, USA. davidballard@wustl.edu.ORCID http://orcid.org/0000-0001-7470-3364

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDespite technical advancements in left ventricular assist devices (LVADs), driveline infections (DLIs) remain a common complication evaluated by CT. The purpose of this study was to assess CT imaging features and clinical variables associated with operative versus non-operative management of LVAD DLIs. MATERIALS/

methodsThis study analyzed 129 patients with LVAD driveline infections evaluated using CT. Two radiologists assessed CT scans for superficial and deep soft tissue stranding and fluid collections. Logistic regression was used to identify predictors of operative management using imaging and clinical variables, guided by Akaike information criterion. Results were reported as odds ratios, and Interreader agreement was evaluated using Cohen's Kappa.

resultsOperative management was performed in 46.8% of patients. Positive driveline cultures (94.8% vs. 43.5%, p < 0.001) and new antibiotic use (98.3% vs. 72.7%, p < 0.001) were strongly associated with operative intervention. Mild subcutaneous fat stranding was the most frequent CT finding (62.6% and 66.9% by Readers 1 and 2, respectively), whereas deep fluid collections were rare (4.8-5.6%). Clinical predictors of operative management included new antibiotic use (p = 0.036), positive cultures (p < 0.001), and LVAD type. The resulting model achieved an AUC of 0.851 and overall accuracy of 78.6%. The absence of superficial fat stranding on CT significantly predicted non-operative management (p < 0.001).

conclusionPositive driveline cultures, recent antibiotic initiation, and absence of skin or subcutaneous fat stranding on CT were associated with non-operative management in LVAD-related driveline infections. Absence of superficial fat stranding on CT may help distinguish suspected driveline infections that are unlikely to require surgical intervention.

Indexed as

Heart-Assist DevicesProsthesis-Related InfectionsTomography, X-Ray ComputedAdultAgedFemaleHumansMaleMiddle AgedRetrospective StudiesClinical predictorsComputed tomographyLeft ventricular assist deviceLVAD driveline infectionSurgery

Identifiers

PMID40627235

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.