Age and Gender Differences and Factors Related to Change in Health-related Quality of Life from Before to 6 Months After Left Ventricular Assist Device Implantation: Findings from Interagency Registry for Mechanically Assisted Circulatory Support

Overview

Journal J Heart Lung Transplant

Publisher Elsevier

Specialties Cardiology & Vascular Diseases
General Surgery
Pulmonary Medicine

Date 2016 Apr 13

PMID 27068037

Citations 29

Authors

Kathleen L Grady

Sherri Wissman

David C Naftel

Susan Myers

Annetine Gelijins

Alan Moskowitz

Francis D Pagani

James B Young

John A Spertus

James K Kirklin

Affiliations

Soon will be listed here.

Abstract

Background: Gaps in the literature exist regarding health-related quality of life (HRQOL) early after left ventricular assist device (LVAD) surgery. The purposes of our study were to describe HRQOL over time, by age and gender, and identify risk factors for poor HRQOL early after LVAD implant.

Methods: Patients (n = 7,353) from the Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) database received a continuous-flow LVAD as a primary implant at 133 United States hospitals. Of these, 5,640 patients had pre-LVAD HRQOL data, 3,353 patients had 6-month post-LVAD HRQOL data, and 2,748 patients had data at both times. HRQOL was measured using the EQ-5D-3L (Euro-Qol) instrument. Data were collected pre-implant and 3 and 6 months post-operatively. Statistical analyses included chi-square test, t-test, Pearson correlation coefficients, and multiple regression analysis.

Results: Overall HRQOL and dimensions of HRQOL improved from before to 6 months after device implant when examined by age and gender. However, younger patients and women reported significantly more problems regarding all dimensions before implant and significantly more problems regarding pain/discomfort and anxiety/depression at 3 and 6 months after implant. An increase in overall HRQOL from before to 6 months after implant was related to pre-implant INTERMACS Level 1. Factors related to a decrease in HRQOL from before to 6 months after implant were listed for heart transplant before surgery, comorbidities, better preoperative HRQOL, adverse events within 6 months after implant, bridge to transplant moderately likely and unlikely, and New York Heart Association Functional Classification IV at 6 months after LVAD (R(2) = 41%).

Conclusions: Overall HRQOL and dimensions of HRQOL improve in sub-groups of patients from before to 6 months after surgery, although differences in improvement exist. Adverse events are risk factors for decreased HRQOL across time and support the ongoing need to improve device technology with the aim of reducing adverse events.

Citing Articles

Sex-based Differences in the Utility and Outcomes of Left Ventricular Assist Devices.

Alasnag M, AlHabeeb W, Khaliel F J Saudi Heart Assoc. 2025; 37(1):6.

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Clinical and cost-effectiveness of left ventricular assist devices as destination therapy for advanced heart failure: systematic review and economic evaluation.

Beese S, Avsar T, Price M, Quinn D, Lim H, Dretzke J Health Technol Assess. 2024; 28(38):1-237.

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Novel measures to assess ventricular assist device patient-reported outcomes: Findings from the MCS A-QOL study.

Grady K, Kallen M, Beiser D, Lindenfeld J, Teuteberg J, Allen L J Heart Lung Transplant. 2023; 43(1):36-50.

PMID: 37591454 PMC: 10867283. DOI: 10.1016/j.healun.2023.08.007.

Impact of Different Therapeutic Strategies With Left Ventricular Assist Devices on Health-Related Quality of Life During Prolonged Device-Based Support.

Asase M, Watanabe T, Takegami M, Nishimura K, Nin K, Fukushima N Circ Rep. 2023; 5(7):289-297.

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Change in Caregiver Health-Related Quality of Life From Before to Early After Surgery: SUSTAIN-IT Study.

Chuzi S, Wilcox J, Kao A, Spertus J, Hsich E, Dew M Circ Heart Fail. 2023; 16(8):e010038.

PMID: 37345518 PMC: 10482357. DOI: 10.1161/CIRCHEARTFAILURE.122.010038.

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