Weerahandi Himali, Goldstein Nathan, Gelfman Laura P, Jorde Ulrich, Kirkpatrick James N, Marble Judith, Naka Yoshifumi, Pinney Sean, Slaughter Mark S, Bagiella Emilia, Ascheim Deborah D
Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
J Pain Symptom Manage. 2016 Oct;52(4):483-490.e1. doi: 10.1016/j.jpainsymman.2016.05.016. Epub 2016 Jul 9.
Ventricular assist devices (VADs) have been shown to improve survival and overall quality of life, but there are limited data on pain control and functional status in this patient population.
This study examined changes in pain, functional status, and quality of life over time in VAD patients.
Patients were enrolled in this prospective cohort study before or as early after VAD implant as possible and then followed for up to 48 weeks. The Brief Pain Inventory was used to assess pain. The Katz Independent Activities of Daily Living questionnaire was used to assess functional status. The Kansas City Cardiomyopathy Questionnaire, a 23-item questionnaire covering five domains (physical function, symptoms, social function, self-efficacy, and quality of life), was used to assess quality of life and health status.
Eighty-seven patients were enrolled at four medical centers. The median Brief Pain Inventory severity score was 2.8 (interquartile range 0.5-5.0) before implantation and 0.0 (interquartile range 0.0-5.3) 48 weeks after implantation (P = 0.0009). Katz Independent Activities of Daily Living summary scores also demonstrated significant improvement over time (P < 0.0001). Kansas City Cardiomyopathy Questionnaire summary scales demonstrated significant improvement with time (P < 0.0016).
This study demonstrated that patients with VADs experienced improved pain, functional status, and quality of life over time. These data may be useful to help patients make decisions when they are considering undergoing VAD implantation.
心室辅助装置(VAD)已被证明可提高生存率和总体生活质量,但关于该患者群体疼痛控制和功能状态的数据有限。
本研究调查了VAD患者疼痛、功能状态和生活质量随时间的变化。
患者在VAD植入前或尽可能早地植入后纳入这项前瞻性队列研究,然后随访长达48周。使用简明疼痛量表评估疼痛。使用Katz日常生活自理能力问卷评估功能状态。堪萨斯城心肌病问卷是一份涵盖五个领域(身体功能、症状、社会功能、自我效能和生活质量)的23项问卷,用于评估生活质量和健康状况。
四个医疗中心共纳入87例患者。植入前简明疼痛量表严重程度评分中位数为2.8(四分位间距0.5 - 5.0),植入后48周为0.0(四分位间距0.0 - 5.3)(P = 0.0009)。Katz日常生活自理能力总结评分也随时间显示出显著改善(P < 0.0001)。堪萨斯城心肌病问卷总结量表随时间显示出显著改善(P < 0.0016)。
本研究表明,VAD患者的疼痛、功能状态和生活质量随时间得到改善。这些数据可能有助于患者在考虑接受VAD植入时做出决策。