CoRPS - Centre of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands.
Eur J Heart Fail. 2014 May;16(5):566-73. doi: 10.1002/ejhf.75. Epub 2014 Mar 11.
Improving patient-reported outcomes (e.g. health status) has become an important goal in left ventricular assist device (LVAD) therapy, in addition to reducing mortality and morbidity. We examined predictors of changes in health status scores between and within patients 12 months post LVAD implantation.
Health status [Kansas City Cardiomyopathy Questionnaire (KCCQ); Short-Form 12 (SF-12)] were assessed at 3-4 weeks after implantation, and at 3, 6 and 12 months follow up in 54 LVAD patients (74% men; mean age 54 ± 9 years).
Patients experienced significant improvements in health status between baseline and 3 months follow-up as assessed by the KCCQ (clinical summary score: F = 33.49, P < 0.001; overall summary score: F = 31.13, P < 0.001) and the SF-12 (physical component score: F = 31.59, P < 0.001; mental component score: F = 21.77, P < 0.001), but not between 3 months and 12 months follow-up (P > 0.05 for all). Higher scores on anxiety and depression over time, older age, lower ejection fraction, and more co-morbidity were associated with poorer health status scores on one or both of the KCCQ and SF-12 subscales. The majority of the between-patient variance of the mental component summary scores (82.6%), but not the KCCQ overall summary score (41.9%), KCCQ clinical summary score (36.2%) and physical component summary scores (23.2%), was explained by the sociodemographic, clinical and psychological factors.
The majority of LVAD patients show a significant improvement in health status after LVAD implantation. However, there are large differences in individual health status score trajectories which are only partly explained by measures of disease severity pre-LVAD, co-morbidity and psychological stress.
除了降低死亡率和发病率外，改善患者报告的结果（例如健康状况）已成为左心室辅助装置（LVAD）治疗的重要目标。我们研究了 LVAD 植入后 12 个月内患者之间和患者内健康状况评分变化的预测因素。
在植入后 3-4 周以及 3、6 和 12 个月的随访中，评估了 54 名 LVAD 患者（74%为男性；平均年龄 54±9 岁）的健康状况[堪萨斯城心肌病问卷（KCCQ）；简短形式 12（SF-12）]。
患者在基线和 3 个月随访之间的健康状况得到了显著改善，这可以通过 KCCQ（临床总结评分：F=33.49，P<0.001；总总结评分：F=31.13，P<0.001）和 SF-12（身体成分评分：F=31.59，P<0.001；精神成分评分：F=21.77，P<0.001）来评估，但在 3 个月和 12 个月随访之间没有差异（P>0.05）。焦虑和抑郁评分随时间的升高、年龄较大、射血分数较低以及合并症较多与 KCCQ 和 SF-12 子量表之一或两者的健康状况评分较差相关。心理因素。
大多数 LVAD 患者在 LVAD 植入后健康状况有显著改善。然而，个体健康状况评分轨迹存在较大差异，而这些差异仅部分可以通过 LVAD 前疾病严重程度、合并症和心理压力的测量来解释。
