期刊
JOURNAL OF HEART AND LUNG TRANSPLANTATION
卷 34, 期 2, 页码 213-221出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.healun.2014.10.001
关键词
quality of life; ventricular assist devices; left ventricular assist devices; mechanical circulatory support; destination therapy; age
资金
- National Heart, Lung, and Blood Institute
- Department of Health and Human Services [HHSN268201100025C]
- American Heart Association
- Alexander von Humboldt Foundation
- American College of Cardiology Foundation
- National Institutes of Health
- Patient-Centered Outcomes Research Trust Fund
- Lilly
- Genentech
- Gilead
- Abbott Vascular
- Eva Heart
BACKGROUND: Destination therapy left ventricular assist devices (DT LVADs) are being implanted in older adults on an increasing basis. Older patients have a higher risk for mortality and morbidity post-LVAD, which may impact their health-related quality of life (HRQOL). We aimed to determine the change in BRQOL by age from before implant to 1 year after DT LVAD implant and identify factors associated with the change. METHODS: Data were collected from 1,470 continuous-flow DT LVAD patients at 108 institutions participating in INTERMACS from January 21, 2010 to March 31, 2012. Patients were divided into three cohorts: <60 years of age (n = 457); 60 to 69 years of age (n = 520); and 70 years of age (n = 493). HRQOL was measured using the generic EuroQol instrument (EQ-5D-3L). Data were collected pre-implant and 3,6 and 12 months post-implant. Statistical analyses included descriptive statistics, Kaplan-Meier survival analyses and multivariable regression analyses. RESULTS: HRQOL improved in all patients. Generally, older patients reported better HRQOL than younger patients pre-implant (>= 70 years: mean 40; 60 to 69 years: mean 33; and <60 years: mean 31; p < 0.0001) and 1 year post-implant (>= 70 years: mean 77; 60 to 69 years: mean 72; <60 years: mean 70; p = 0.01) using the EQ-5D visual analog scale (VAS), with 0 = worst imaginable health state and 100 = best imaginable health state. The magnitude of improvement in EQ-5D scores from pre-implant to 1-year post-LVAD implant was similar in all age groups (>= 70 years: mean change 33; 60 to 69 years: mean change 35; <60 years: mean change 35; p = 0.77). Factors associated with improvement in HRQOL from before to 1 year after implant were a lower VAS score pre-implant and fewer rehospitalizations post-implant (R-2 = 61.3%, p < 0.0001). CONCLUSIONS: Older patients reported better BRQOL than younger patients before and after LVAD implantation. The magnitude of improvement was similar for all age groups, with >70% of all patients showing clinically significant increases (> 10 points on the VAS). Rehospitalization appears to reduce the magnitude of improvement. (C) 2015 International Society for Heart and Lung Transplantation. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据