دورية أكاديمية
Association of Psychosocial Risk Factors With Quality of Life and Readmissions 1 Year After LVAD Implantation.
| العنوان: | Association of Psychosocial Risk Factors With Quality of Life and Readmissions 1 Year After LVAD Implantation. |
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| المؤلفون: | Wang J; Emory University School of Medicine, Division of Cardiology, Atlanta, GA., Okoh AK; Emory University School of Medicine, Division of Cardiology, Atlanta, GA., Chen Y; Emory University Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Atlanta, GA., Steinberg RS; Emory University School of Medicine, Division of Cardiology, Atlanta, GA., Gangavelli A; Emory University School of Medicine, Division of Cardiology, Atlanta, GA., Patel KJ; Emory University School of Medicine, Division of Cardiology, Atlanta, GA., Ko YA; Emory University Rollins School of Public Health, Department of Biostatistics and Bioinformatics, Atlanta, GA., Alexis JD; University of Rochester Medical Center, Division of Cardiology, Rochester, NY., Patel SA; Emory University Rollins School of Public Health, Hubert Department of Global Health, Atlanta, GA., Vega DJ; Emory University School of Medicine, Department of Surgery, Atlanta, GA., Daneshmand M; Emory University School of Medicine, Department of Surgery, Atlanta, GA., Defilippis EM; Center for Advanced Cardiac Care, Columbia University Irving Medical Center, Division of Cardiology, New York, NY., Breathett K; Indiana University School of Medicine, Division of Cardiology, Indianapolis, IN., Morris AA; Emory University School of Medicine, Division of Cardiology, Atlanta, GA. Electronic address: aamorr3@emory.edu. |
| المصدر: | Journal of cardiac failure [J Card Fail] 2024 Apr 15. Date of Electronic Publication: 2024 Apr 15. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Churchill Livingstone Country of Publication: United States NLM ID: 9442138 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8414 (Electronic) Linking ISSN: 10719164 NLM ISO Abbreviation: J Card Fail Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: <2002->: Philadelphia, PA : Churchill Livingstone Original Publication: Naperville, IL : Churchill Livingstone, c1994- |
| مستخلص: | Background: Among patients with advanced heart failure (HF), treatment with a left ventricular assist device (LVAD) improves health-related quality of life (HRQOL). We investigated the association between psychosocial risk factors, HRQOL and outcomes after LVAD implantation. Methods: A retrospective cohort (n = 9832) of adults aged ≥ 19 years who received durable LVADs between 2008 and 2017 was identified by using the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS). Patients were considered to have psychosocial risk factors if ≥ 1 of the following were present: (1) substance abuse; (2) limited social support; (3) limited cognitive understanding; (4) repeated nonadherence; and (5) major psychiatric disease. Multivariable logistic and linear regression models were used to evaluate the association between psychosocial risk factors and change in Kansas City Cardiomyopathy Questionnaire (KCCQ)-12 scores from baseline to 1 year, persistently poor HRQOL (KCCQ-12 score < 45 at baseline and 1 year), and 1-year rehospitalization. Results: Among the final analytic cohort, 2024 (20.6%) patients had ≥ 1 psychosocial risk factors. Psychosocial risk factors were associated with a smaller improvement in KCCQ-12 scores from baseline to 1 year (mean ± SD, 29.1 ± 25.9 vs 32.6 ± 26.1; P = 0.015) for a difference of -3.51 (95% confidence interval [CI]: -5.88 to -1.13). Psychosocial risk factors were associated with persistently poor HRQOL (adjusted odds ratio [aOR] 1.35, 95% confidence interval [CI] 1.04-1.74), and 1-year all-cause readmission (adjusted hazard ratio [aHR] 1.11, 95% CI 1.05-1.18). Limited social support, major psychiatric disorder and repeated nonadherence were associated with persistently poor HRQOL, while major psychiatric disorder was associated with 1-year rehospitalization. Conclusion: The presence of psychosocial risk factors is associated with lower KCCQ-12 scores and higher risk for readmission at 1 year after LVAD implantation. These associations are statistically significant, but further research is needed to determine whether these differences are clinically meaningful. Competing Interests: Disclosures JW is supported by funding from the GA CTSA (UL1TR002378, TL1TR002382) and the National Heart, Lung and Blood Institute of the National Institutes of Health under award number 5T32HL007745. AAM is supported by funding from the American Heart Association and the Agency for Health Research and Quality (HS026081) and reports consulting fees or honoraria from Abbott, Acorai, BI Lilly, Cytokinetics, Edwards Lifesciences, Ionis, Merck and Regeneron. AKO is supported by funding from the American Heart Association. KB is supported by funding from the National Heart, Lung, and Blood Institute (NHLBI)K01HL142848, R01HL159216, R01HL160734 and funding from the Health Resources and Services Administration of the U.S. Department of Health and Human Services. All other authors report no disclosures. (Copyright © 2024 Elsevier Inc. All rights reserved.) |
| تواريخ الأحداث: | Date Created: 20240415 Latest Revision: 20240504 |
| رمز التحديث: | 20240505 |
| DOI: | 10.1016/j.cardfail.2024.03.011 |
| PMID: | 38621441 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1532-8414 |
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| DOI: | 10.1016/j.cardfail.2024.03.011 |